Multidetector CT Arthrography of the Wrist Joint: How to Do It

Abstract

With its exquisite spatial resolution, multidetector computed tomographic (CT) arthrography of the wrist is a valuable tool for the diagnosis and evaluation of a wide spectrum of articular disorders. Traumatic tears of the interosseous ligaments can be classified as complete or incomplete and as partial- or full-thickness tears at multidetector CT arthrography and can also be differentiated from asymptomatic degenerative lesions. In addition, tears of the triangular fibrocartilage complex can be differentiated according to their location. A tailored contrast material injection technique and multiplanar reformation are recommended for optimal assessment of these structures. Multidetector CT arthrography is also remarkably effective in demonstrating cartilage and bone abnormalities, many of which cannot be depicted with other imaging techniques. The chief limitation of multidetector CT arthrography lies in the evaluation of soft-tissue abnormalities, which may benefit from the addition of other imaging techniques such as ultrasonography or magnetic resonance imaging. A basic knowledge of the relevant anatomy, pathophysiologic features, and imaging technique is mandatory for obtaining high-yield diagnostic information concerning the wrist joint. (c) RSNA, 2008.

Advanced imaging of the scapholunate ligamentous complex

“…To obtain a CTA, an iodine concentration <300 mg/ml is recommended to avoid beam-hardening artifacts. The injected volume should be sufficient to obtain a good delineation of articular structures and is typically 1-2 ml for the midcarpal compartment, 0.5-1 ml for the DRUJ, and 1-2 ml for the radiocarpal compartment [24,30]. According to the studies of the literature, CTA has different sensitivity and specificity rates.…”

“…10). Fullthickness tears of one segment (usually communicating) m i g h t b e d i ff e r e n t i a t e d f r o m p a r t i a l -t h i c k n e s s (noncommunicating) tears on CTA [30] (Fig. 11).…”

The Hand and Wrist: Acquired Disorders

“…Tears are classifi ed as complete if all three portions of either the scapholunate or the lunotriquetral ligaments are disrupted. Most patients with partial tears can be treated conservatively and have no sign of wrist instability [ 57 ]. Tears of the dorsal and volar components are usually posttraumatic and associated with wrist pain, whereas central (membranous) tears are usually due to degeneration and can be asymptomatic [ 58 ].…”

Prevalence of Triangular Fibrocartilage Complex Abnormalities among Asymptomatic Young Individuals Using Magnetic Resonance Imaging in A Tertiary Center in Saudi Arabia: A Cross-Sectional Study

“…For simplicity, its anatomy has been divided into three portions including the midcarpal joint, the radiocarpal joint, and the radioulnar joint (DRUJ) [1]. The key anatomic structure in wrist is the triangular fibrocartilage complex (TFCC) that functions to stabilize DRUJ and regulates load transmission from the ulnar side of wrist.…”