CT Hand Without and With IV Contrast There is no relevant literature to support the use of CT hand with IV contrast in the setting of chronic hand pain and normal radiographs or radiographs remarkable for nonspecific arthritis. CT Hand Without IV Contrast There is no relevant literature to support the use of CT hand without IV contrast in the setting of chronic hand pain and normal radiographs or radiographs remarkable for nonspecific arthritis. MR Arthrography Hand There is no relevant literature to support the use of MR arthrography in the setting of chronic hand pain and normal radiographs or radiographs remarkable for nonspecific arthritis. MRI Hand Without and With IV Contrast There is no relevant literature discussing routine use of MRI hand without and with IV contrast in the setting of chronic hand pain and normal radiographs or radiographs remarkable for nonspecific arthritis. In the research setting, contrast-enhanced MRI can identify synovitis, periarticular bone marrow edema, and tenosynovitis, which correlates with patient pain in the setting of hand osteoarthritis [47,48]. MRI Hand Without IV Contrast MRI hand without IV contrast is of limited benefit in the setting of nonspecific pain. A study evaluating hand MRI in the setting of erosive osteoarthritis showed no difference in the assessment of joint space narrowing, bone erosion, and malalignment compared with radiographs [49]. MRI can demonstrate many abnormalities that result in chronic pain including arthritis, carpal boss, tendinopathy, tenosynovitis, pulley injury, extensor hood injury, sagittal band injury, volar plate injury, chondral injury, and ligament injury [13,50-54]. In a retrospective review of 316 consecutive patients referred to a hand surgeon with MRI of the hand or wrist, MRI changed clinical management in 69.5% of cases [44]. MRI was particularly useful in reassuring patients that no further follow-up was necessary in 70% of cases [44].
Chronic Hand and Wrist Pain. CT Hand Without and With IV Contrast There is no relevant literature to support the use of CT hand with IV contrast in the setting of chronic hand pain and normal radiographs or radiographs remarkable for nonspecific arthritis. CT Hand Without IV Contrast There is no relevant literature to support the use of CT hand without IV contrast in the setting of chronic hand pain and normal radiographs or radiographs remarkable for nonspecific arthritis. MR Arthrography Hand There is no relevant literature to support the use of MR arthrography in the setting of chronic hand pain and normal radiographs or radiographs remarkable for nonspecific arthritis. MRI Hand Without and With IV Contrast There is no relevant literature discussing routine use of MRI hand without and with IV contrast in the setting of chronic hand pain and normal radiographs or radiographs remarkable for nonspecific arthritis. In the research setting, contrast-enhanced MRI can identify synovitis, periarticular bone marrow edema, and tenosynovitis, which correlates with patient pain in the setting of hand osteoarthritis [47,48]. MRI Hand Without IV Contrast MRI hand without IV contrast is of limited benefit in the setting of nonspecific pain. A study evaluating hand MRI in the setting of erosive osteoarthritis showed no difference in the assessment of joint space narrowing, bone erosion, and malalignment compared with radiographs [49]. MRI can demonstrate many abnormalities that result in chronic pain including arthritis, carpal boss, tendinopathy, tenosynovitis, pulley injury, extensor hood injury, sagittal band injury, volar plate injury, chondral injury, and ligament injury [13,50-54]. In a retrospective review of 316 consecutive patients referred to a hand surgeon with MRI of the hand or wrist, MRI changed clinical management in 69.5% of cases [44]. MRI was particularly useful in reassuring patients that no further follow-up was necessary in 70% of cases [44].