If the specific clinical concern requires assessment of the articular cartilage in post-traumatic osteoarthritis, the addition of arthrography to MRI improves the assessment of the articular cartilage [31]. However, CT arthrography has a higher sensitivity and specificity for articular cartilage defect compared with MR arthrography [31,56]. MRI Wrist Without and With IV Contrast MRI wrist without and with IV contrast can demonstrate both nonunited and malunited scaphoid fractures. Although 3.0T MRI without IV contrast falls behind MR and CT arthrography in the assessment of the articular cartilage, it has demonstrated a modest sensitivity of 48% to 52% and a good specificity of 82% compared with visual inspection in a cadaver study [57]. The added benefit of MRI comes in the assessment for osteonecrosis in the proximal pole scaphoid following scaphoid fracture. Whether contrast-enhanced MRI is superior to noncontrast MRI for assessment of scaphoid osteonecrosis is controversial. In a study comparing the addition of postcontrast images with the unenhanced MRI in 30 patients, the addition of contrast increased the sensitivity (66% versus 36%), specificity (88% versus 78%), and accuracy (83% versus 68%) when compared with the noncontrast images alone [58]. MRI Wrist Without IV Contrast MRI wrist without IV contrast can demonstrate both nonunited and malunited scaphoid fractures. Although 3.0T MRI without IV contrast falls behind MR and CT arthrography in the assessment of the articular cartilage, it has demonstrated a modest sensitivity of 48% to 52% and a good specificity of 82% compared with visual inspection in a cadaver study [57]. The added benefit of MRI comes in the assessment for osteonecrosis in the proximal pole scaphoid following scaphoid fracture. Whether contrast-enhanced MRI is superior to noncontrast MRI for assessment of scaphoid osteonecrosis is controversial. A study of noncontrast MRI in 29 patients with scaphoid Chronic Hand and Wrist Pain
Chronic Hand and Wrist Pain. If the specific clinical concern requires assessment of the articular cartilage in post-traumatic osteoarthritis, the addition of arthrography to MRI improves the assessment of the articular cartilage [31]. However, CT arthrography has a higher sensitivity and specificity for articular cartilage defect compared with MR arthrography [31,56]. MRI Wrist Without and With IV Contrast MRI wrist without and with IV contrast can demonstrate both nonunited and malunited scaphoid fractures. Although 3.0T MRI without IV contrast falls behind MR and CT arthrography in the assessment of the articular cartilage, it has demonstrated a modest sensitivity of 48% to 52% and a good specificity of 82% compared with visual inspection in a cadaver study [57]. The added benefit of MRI comes in the assessment for osteonecrosis in the proximal pole scaphoid following scaphoid fracture. Whether contrast-enhanced MRI is superior to noncontrast MRI for assessment of scaphoid osteonecrosis is controversial. In a study comparing the addition of postcontrast images with the unenhanced MRI in 30 patients, the addition of contrast increased the sensitivity (66% versus 36%), specificity (88% versus 78%), and accuracy (83% versus 68%) when compared with the noncontrast images alone [58]. MRI Wrist Without IV Contrast MRI wrist without IV contrast can demonstrate both nonunited and malunited scaphoid fractures. Although 3.0T MRI without IV contrast falls behind MR and CT arthrography in the assessment of the articular cartilage, it has demonstrated a modest sensitivity of 48% to 52% and a good specificity of 82% compared with visual inspection in a cadaver study [57]. The added benefit of MRI comes in the assessment for osteonecrosis in the proximal pole scaphoid following scaphoid fracture. Whether contrast-enhanced MRI is superior to noncontrast MRI for assessment of scaphoid osteonecrosis is controversial. A study of noncontrast MRI in 29 patients with scaphoid Chronic Hand and Wrist Pain