Common indications for MRI of the hand and wrist
What are some common indications for performing magnetic resonance imaging (MRI) of the hand and wrist?
MRI of the wrist is routinely used to assess a wide variety of osseous and soft tissues abnormalities, including radiographically occult fractures; tendon, ligament, or cartilage injuries; tunnel syndromes; palpable abnormalities; and wrist pain. This chapter will concentrate predominantly on MRI of the wrist.
MRI of the hand is obtained much less frequently than MRI of the wrist. It is technically demanding, requires special techniques and equipment not widely available, and consistent, high-quality images are more difficult to obtain. Moreover, ultrasonography (US) has emerged as a strong competitor with both higher resolution than MRI and the capacity to image small structures during the passive or active performance of maneuvers. The downside to US is the shortage of both technologists and radiologists qualified to perform and interpret the studies.
MRI of the hand is occasionally used for the assessment of injury to the flexor and extensor tendons, as well as injury to the complex pulley system used to stabilize the flexor tendons. MRI is also sometimes used to assess injury to periarticular soft tissues such as the joint capsule and collateral ligaments as well as the volar plates (focal thickenings of the joint capsule) of the metacarpophalangeal and interphalangeal joints. The only periarticular structure that is commonly studied with MRI is the ulnar collateral ligament (UCL) of the carpometacarpal joint of the thumb. Other uses of MRI include assessment of either bony or soft tissue infection as well as of soft tissue masses.