MRI of the wrist is a fairly frequent examination in musculoskeletal radiology practice and not quite as common in general radiological practice. This approach is an example of how to create a radiological report of an MRI of the wrist with coverage of the most common anatomical sites of possible pathology, within the wrist.
On this page:
Systematic review
A systematic review in the MRI of the wrist is essential since wrist anatomy itself is a complex entity with small structures, pathologies and injury patterns that are manifold and involve a whole lot of different therapeutical approaches.
Bones
The bony structures of the wrist, the pictured distal radius and ulna to the bases and proximal parts of the metacarpals are assessed including the proximal and distal row of carpal bones.
fractures, dislocations, erosions
Joint space and capsule
Assessment of the following structures:
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joint space
joint effusion if present and possible intra-articular fragments or loose bodies
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synovial thickening and hyperenhancement and other abnormalities
Radiocarpal articulation and midcarpus
Assessment of the following structures and their alignment:
proximal carpal row: scaphoid, lunate, triquetrum (pisiform)
distal carpal row: trapezium, trapezoid capitate and hamate bones
variant anatomy: lunate type, carpal boss
Extrinsic carpal ligaments
palmar radiocarpal ligaments
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dorsal radiocarpal ligaments
Intrinsic carpal ligaments
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proximal interosseous ligaments: scapholunate (SL), lunotriquetral ligament (LT)
midcarpal ligaments
distal carpal interosseous ligaments
Ulnocarpal articulation and distal radioulnar joint (DRUJ)
Assessment of the following structures:
ulnocarpal ligaments: ulnolunate ligament, ulnotriquetral ligament
Extensor compartments and tendons
Assessment of the following structures:
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Extensor compartments of the wrist
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Variant anatomy
Thenar soft tissues, carpal tunnel and flexor tendons
Assessment of the following structures:
radial and ulnar palmar bursae
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flexor digitorum profundus, flexor digitorum superficialis and flexor pollicis longus tendons
tenosynovitis, bursitis, rice bodies, tenosynovial giant cell tumor
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flexor retinaculum (transverse carpal ligament)
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variant anatomy
Hypothenar soft tissues, Guyon’s canal
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tenosynovitis
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pisiform bone
Guyon’s canal: superficial/deep ulnar nerve, ulnar artery
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Variant anatomy: anomalous muscles
Guyon’s canal syndrome, ganglion cysts, lipoma, PNST, hypothenar hammer syndrome
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variant anatomy