MRI Wrist Distal radioulnar joint instability and traumatic triangular fibrocartilage injuries are usually associated with fluid in the distal radioulnar joint, which aids in the evaluation of the triangular fibrocartilage components on conventional MRI. MR Arthrography Wrist MR arthrography increases the diagnostic accuracy for proximal lamina (foveal) triangular fibrocartilage tears [56,57]. US Wrist US is not indicated in this clinical setting. Bone Scan Wrist Bone scan is not indicated in this clinical setting. Variant 5: Acute hand fracture on radiographs. Suspect hand tendon or ligament trauma. Next imaging study. CT Hand CT has limited use for the diagnosis of soft-tissue injuries of the hand. Acute Hand and Wrist Trauma MRI Hand MRI is ideal for evaluating tendon injuries and helping with surgical planning [58,59]. MRI is commonly used for the diagnosis of Stener lesions of the thumb [60] and the diagnosis of pulley system injuries [61]. Hergan et al [62] reported a 100% sensitivity and specificity for assessment of thumb ulnar collateral ligament tears. Spaeth et al [63] reported a sensitivity of 100% and specificity of 94% for detection of displaced ulnar collateral ligament tears in 16 cadaveric specimens. US Hand A Stener lesion occurs when the aponeurosis of the adductor pollicis muscle becomes interposed between the ruptured ulnar collateral ligament of the thumb and its site of insertion at the base of the proximal phalanx. This lesion can be identified by absence of ulnar collateral ligament and the presence of a hypoechoic mass proximal to the apex of the metacarpal tubercle [64]. Dynamic examination shows the relationship of the aponeurosis to the retracted ligament stump [65]. US allows for diagnosis of pulley system injuries [66,67]. Bone Scan Hand Bone scan is not indicated in this clinical setting. Variant 6: Initial radiographs showing metacarpophalangeal, proximal interphalangeal, or distal interphalangeal joint malalignment in the absence of fracture.
Acute Hand and Wrist Trauma. MRI Wrist Distal radioulnar joint instability and traumatic triangular fibrocartilage injuries are usually associated with fluid in the distal radioulnar joint, which aids in the evaluation of the triangular fibrocartilage components on conventional MRI. MR Arthrography Wrist MR arthrography increases the diagnostic accuracy for proximal lamina (foveal) triangular fibrocartilage tears [56,57]. US Wrist US is not indicated in this clinical setting. Bone Scan Wrist Bone scan is not indicated in this clinical setting. Variant 5: Acute hand fracture on radiographs. Suspect hand tendon or ligament trauma. Next imaging study. CT Hand CT has limited use for the diagnosis of soft-tissue injuries of the hand. Acute Hand and Wrist Trauma MRI Hand MRI is ideal for evaluating tendon injuries and helping with surgical planning [58,59]. MRI is commonly used for the diagnosis of Stener lesions of the thumb [60] and the diagnosis of pulley system injuries [61]. Hergan et al [62] reported a 100% sensitivity and specificity for assessment of thumb ulnar collateral ligament tears. Spaeth et al [63] reported a sensitivity of 100% and specificity of 94% for detection of displaced ulnar collateral ligament tears in 16 cadaveric specimens. US Hand A Stener lesion occurs when the aponeurosis of the adductor pollicis muscle becomes interposed between the ruptured ulnar collateral ligament of the thumb and its site of insertion at the base of the proximal phalanx. This lesion can be identified by absence of ulnar collateral ligament and the presence of a hypoechoic mass proximal to the apex of the metacarpal tubercle [64]. Dynamic examination shows the relationship of the aponeurosis to the retracted ligament stump [65]. US allows for diagnosis of pulley system injuries [66,67]. Bone Scan Hand Bone scan is not indicated in this clinical setting. Variant 6: Initial radiographs showing metacarpophalangeal, proximal interphalangeal, or distal interphalangeal joint malalignment in the absence of fracture.