MDCT Arthrography or MR Arthrography for Imaging the Wrist Joint?

Thomas Moser; Viviane Khoury; Patrick G. Harris; Nathalie J. Bureau; Etienne Cardinal; Jean-Claude Dosch

doi:10.1055/s-0029-1202244

Seminars in Musculoskeletal Radiology, Table of Contents

Semin Musculoskelet Radiol 2009; 13(1): 039-054
DOI: 10.1055/s-0029-1202244

MDCT Arthrography or MR Arthrography for Imaging the Wrist Joint?

Thomas Moser¹ ^, ² , Viviane Khoury³ , Patrick G. Harris⁴ , Nathalie J. Bureau² , Etienne Cardinal² , Jean-Claude Dosch¹

¹Department of Radiology, CHU Strasbourg, Hôpital de Hautepierre, Strasbourg, France
²Department of Radiology, CHUM, Hôpital St-Luc, Montreal, Quebec, Canada
³Department of Radiology, McGill University Health Center, Montreal, Quebec, Canada
⁴Department of Surgery, Division of Plastic Surgery, CHUM, Hôpital Notre-Dame, Montreal, Quebec, Canada

Abstract

ABSTRACT

Imaging of the wrist joint has been radically modified over the last decade, particularly since multidetector computed tomography (MDCT) arthrography and magnetic resonance (MR) arthrography have become widely available. These two modalities allow a confident assessment of ligament tears and potential diagnosis of associated abnormalities of cartilage, bone, and soft tissues. The interosseous scapholunate and lunotriquetral ligaments and the triangular fibrocartilage complex (TFCC) are the most important structures to consider. Precise analysis of their different lesions, including recognition of degenerative tears, is essential for guiding the treatment.

After a brief overview of the different injuries of interosseous ligaments and cartilage, this article thoroughly exposes the technical aspects of wrist MDCT arthrography and MR arthrography, reviews their results, and discusses their performances in light of recent literature. Finally, we propose an imaging strategy to decide between MDCT arthrography and MR arthrography depending on the clinical query. Other imaging modalities are not forgotten in this strategy. The evaluation of ligamentous and TFCC pathology must always begin with conventional radiographs. Cineradiography, ultrasound, and standard MRI are also useful in selected cases.

KEYWORDS

Wrist - ligaments - cartilage - scapholunate - lunotriquetral - triangular fibrocartilage complex - MDCT arthrography - MR arthrography

Full Text

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Thomas MoserM.D.

Department of Radiology, CHU Strasbourg, Hôpital de Hautepierre, Avenue Molière

67098 Strasbourg Cedex, France

Email: thomas.p.moser@gmail.com