Injection of any combination of the 3 compartments (DRUJ, radiocarpal, midcarpal) can be performed depending on the clinical question [13]. If the injection is performed with fluoroscopy, Chronic Hand and Wrist Pain comparison of the MR images with the fluoroscopic images is an essential step in image interpretation [13]. In most cases, a radiocarpal injection is performed; however, if there is concern for an ulnar sided detachment of the TFC, an additional DRUJ injection should be considered [7]. With single, radiocarpal injection, the sensitivity for TFC tears, intrinsic ligament injury, and cartilage lesions of the radiocarpal joint ranged from 63% to 100%, with specificity ranging from 89% to 97% [29]. MRI Wrist Without and With IV Contrast There is no relevant literature discussing the routine use of MRI wrist without and with IV contrast for the evaluation of chronic wrist pain and normal or nonspecific radiographs. The addition of postcontrast imaging to wrist MRI aids in distinguishing synovitis from joint effusion and ganglion cysts [9,35]. Similarly, postcontrast MRI aids in the detection of tenosynovitis [35]. For these reasons, MRI without and with IV contrast is usually appropriate in the evaluation of chronic joint pain with clinical suspicion of rheumatoid arthritis or seronegative spondyloarthropathy [2] and in cases of suspected septic arthritis or soft tissue infection [3]. MRI Wrist Without IV Contrast MRI without IV contrast is useful in the assessment of wrist pain. MRI is useful in assessing abnormalities of the bones, including bone marrow, and soft tissues, including the ligaments, TFC, tendons, and nerves. When using arthroscopy as the reference standard, the sensitivity and specificity of 3.0T MRI in the evaluation of scapholunate tear range from 70% to 87% and 90% to 97%, respectively, for lunotriquetral tear range from 50% to 63% and 94% to 97% respectively, and for TFC tear range from 63% to 100% and 42% to 100%, respectively [32,36-40].
Chronic Hand and Wrist Pain. Injection of any combination of the 3 compartments (DRUJ, radiocarpal, midcarpal) can be performed depending on the clinical question [13]. If the injection is performed with fluoroscopy, Chronic Hand and Wrist Pain comparison of the MR images with the fluoroscopic images is an essential step in image interpretation [13]. In most cases, a radiocarpal injection is performed; however, if there is concern for an ulnar sided detachment of the TFC, an additional DRUJ injection should be considered [7]. With single, radiocarpal injection, the sensitivity for TFC tears, intrinsic ligament injury, and cartilage lesions of the radiocarpal joint ranged from 63% to 100%, with specificity ranging from 89% to 97% [29]. MRI Wrist Without and With IV Contrast There is no relevant literature discussing the routine use of MRI wrist without and with IV contrast for the evaluation of chronic wrist pain and normal or nonspecific radiographs. The addition of postcontrast imaging to wrist MRI aids in distinguishing synovitis from joint effusion and ganglion cysts [9,35]. Similarly, postcontrast MRI aids in the detection of tenosynovitis [35]. For these reasons, MRI without and with IV contrast is usually appropriate in the evaluation of chronic joint pain with clinical suspicion of rheumatoid arthritis or seronegative spondyloarthropathy [2] and in cases of suspected septic arthritis or soft tissue infection [3]. MRI Wrist Without IV Contrast MRI without IV contrast is useful in the assessment of wrist pain. MRI is useful in assessing abnormalities of the bones, including bone marrow, and soft tissues, including the ligaments, TFC, tendons, and nerves. When using arthroscopy as the reference standard, the sensitivity and specificity of 3.0T MRI in the evaluation of scapholunate tear range from 70% to 87% and 90% to 97%, respectively, for lunotriquetral tear range from 50% to 63% and 94% to 97% respectively, and for TFC tear range from 63% to 100% and 42% to 100%, respectively [32,36-40].