Abstract
The study of the wrist represents a major diagnostic challenge because of its complex
anatomy and the small size of individual structures. Recent advances in imaging techniques
have increased our diagnostic capabilities. However, 3T magnets, multichannel specific
wrist coils, and new MRI sequences have not restricted the indications of arthrographic
imaging techniques (CT arthrography and MR arthrography). Distension of the different
wrist compartments at CT arthrography and MR arthrography significantly improves the
diagnostic accuracy for triangular fibrocartilage (TFC) complex injuries and carpal
instability. Dedicated multichannel wrist coils are essential for an adequate study
of the wrist, but the placement of these coils and the positioning of the wrist are
also important for proper diagnosis. The development of dynamic multislice CT studies
allows a diagnostic approach that combines dynamic information and the accurate assessment
of ligaments and the TFC complex. New advances in arthroscopy have changed the anatomical
description of the TFC with a functional division in the proximal and distal TFC complex,
and they have allowed a better characterization of lesions of the TFC complex with
subclassification of Palmer 1B and 1D lesions and description of new lesions not included
in the Palmer classification, such as capsular injuries.
Keywords
triangular fibrocartilage - arthrography - MR arthrography - CT arthrography - wrist
- ulnar impaction - carpal instability
