Role of MR arthrography for evaluation of wrist ligamentous injuries

What is the role of MR arthrography for evaluation of wrist ligamentous injuries?

In some cases of ligamentous injury, the ligament may appear thinned rather than discontinuous and there may be no joint fluid present to highlight the defect. In addition, although tears of the mechanically insignificant proximal segment are generally well seen, tears of the much stronger dorsal and volar segments are often harder to detect. In such cases, MR arthrography may be a useful adjunct. MR arthrography consists of the injection of a small amount of dilute gadolinium-based contrast material into the radiocarpal joint under fluoroscopic guidance followed by MRI. The contrast passes through defects in the scapholunate and lunatotriquetral ligaments and can often identify tears that are not seen well on conventional MRI studies, including those in the more mechanically significant dorsal and volar components. MR arthrography does have the disadvantages of being mildly invasive with the attendant risks of infection, hemorrhage, and contrast reaction, and of requiring the use of fluoroscopic equipment close to the MRI system.

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