Normal wrist arthrograms

Case contributed by Dr Dai Roberts

Presentation

FOOSH. ? scapholunate ligament injury

Patient Data

Age: 30 years
Gender: Male
Fluoroscopy

Arthrogram injection pre MRI

Technically successful wrist joint arthrogram injection. The proximal pole of the scaphoid is targeted with a 25G needle using an oblique approach. The first image stack is taken during injection of the iodinated contrast which extends from the needle to fill the wrist joint confirming an intra-articular position. The second stack of images is taken during the injection of the arthrogram solution. 

The images show ulnar negative variance. No extravasation of contrast into the DRUJ, although this would not be expected as TFC tears usually don't occur in those with ulnar negative variance.

MRI

MRI arthrogram

Normal wrist MRA. 

No widening of the scapholunate interval or tear of the scapholunate ligaments.  

Case Discussion

The proximal pole of the scaphoid is one target point for performing wrist arthrography as demonstrated in this case. Another one is the central aspect of the lunate.  

Further reading available on Arthrogram (MRI)

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Case information

rID: 75566
Published: 1st Apr 2020
Last edited: 5th Apr 2020
Inclusion in quiz mode: Included
Institution: St. Paul's Hospital