In a study assessing the diagnostic performance of CT arthrography in cadavers, CT arthrography was more sensitive for the diagnosis of scapholunate and lunotriquetral tears when compared with MRI at 1.5T and performed particularly well in assessment of the dorsal segment of the scapholunate ligament [23]. CT Wrist With IV Contrast There is no relevant literature to support the use of CT wrist with IV contrast in the setting of chronic wrist pain and normal radiographs or radiographs remarkable for nonspecific arthritis. CT Wrist Without and With IV Contrast There is no relevant literature to support the use of CT wrist without and with IV contrast in the setting of chronic wrist pain and normal radiographs or radiographs remarkable for nonspecific arthritis. CT Wrist Without IV Contrast CT of the wrist provides a detailed assessment of the cortical and trabecular bone with a high spatial resolution. CT is the ideal modality to assess fracture healing, malunion, and articular surface incongruity [6,24]. CT is particularly useful in assessment of the DRUJ. When there is clinical concern for DRUJ instability, CT can be used to image the symptomatic and contralateral wrist simultaneously in the neutral, supinated, and pronated positions to assess for instability [24-26]. CT without IV contrast has been shown to be beneficial in operative planning for scaphoid fracture [27,28]. A disadvantage of CT compared with both MRI and US is its decreased contrast resolution and lower sensitivity in the detection of soft tissue abnormalities. MR Arthrography Wrist Direct MR arthrography is performed following the intra-articular injection of gadolinium and improves the detection and interobserver agreement for abnormalities of the wrist. MR arthrography is a minimally invasive imaging examination that may be appropriate for cases of suspected intrinsic ligament injury, TFC complex injury, cartilage abnormality, or surgical planning.
Chronic Hand and Wrist Pain. In a study assessing the diagnostic performance of CT arthrography in cadavers, CT arthrography was more sensitive for the diagnosis of scapholunate and lunotriquetral tears when compared with MRI at 1.5T and performed particularly well in assessment of the dorsal segment of the scapholunate ligament [23]. CT Wrist With IV Contrast There is no relevant literature to support the use of CT wrist with IV contrast in the setting of chronic wrist pain and normal radiographs or radiographs remarkable for nonspecific arthritis. CT Wrist Without and With IV Contrast There is no relevant literature to support the use of CT wrist without and with IV contrast in the setting of chronic wrist pain and normal radiographs or radiographs remarkable for nonspecific arthritis. CT Wrist Without IV Contrast CT of the wrist provides a detailed assessment of the cortical and trabecular bone with a high spatial resolution. CT is the ideal modality to assess fracture healing, malunion, and articular surface incongruity [6,24]. CT is particularly useful in assessment of the DRUJ. When there is clinical concern for DRUJ instability, CT can be used to image the symptomatic and contralateral wrist simultaneously in the neutral, supinated, and pronated positions to assess for instability [24-26]. CT without IV contrast has been shown to be beneficial in operative planning for scaphoid fracture [27,28]. A disadvantage of CT compared with both MRI and US is its decreased contrast resolution and lower sensitivity in the detection of soft tissue abnormalities. MR Arthrography Wrist Direct MR arthrography is performed following the intra-articular injection of gadolinium and improves the detection and interobserver agreement for abnormalities of the wrist. MR arthrography is a minimally invasive imaging examination that may be appropriate for cases of suspected intrinsic ligament injury, TFC complex injury, cartilage abnormality, or surgical planning.