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MRI and MR Arthrography

  • Chapter
Book cover Imaging of the Hand and Wrist

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

The complex anatomical nature of the hand and wrist brings about diagnostic challenges both for the Clinician and the Radiologist when considering pathology in this region. MR is a proven, widely employed imaging modality used in the detection, assessment and follow-up of disorders of both the hand and the wrist. Optimisation of both sequences and protocols are essential in order to provide good quality images which allow high sensitivity and specificity for detection of pathology. High field strength units are usually used in hand and wrist imaging alongside dedicated extremity coils. Even then, there are numerous artefacts which may be encountered including movement, pulsation, truncation, magic angle and chemical shift. These phenomena will be discussed in this chapter in addition to a brief outline of sequences and their potential uses. Pathology relating to osseous structures, tendons, TFCC and both intrinsic and extrinsic ligaments are all readily assessed on MR imaging and the optimal planes for imaging are discussed alongside common pathologies and potential pitfalls in image interpretation. MR arthrography is also discussed with particular reference to both TFCC and intrinsic ligament pathology. Recent advances in technology, including the advent of 7T units, have led to improvements in the assessment of articular cartilage at the wrist and techniques of biological imaging, which continue to evolve.

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References

  • Alam F, Schweitzer ME, Li XX, Malat J, Hussain SM (1999) Frequency and spectrum of abnormalities in the bone marrow of the wrist: MR imaging findings. Skeletal Radiol 28(6):312–317

    Article  PubMed  CAS  Google Scholar 

  • Amrami KK, Felmlee JP (2008) 3-Tesla imaging of the wrist and hand: techniques and applications. Semin musculoskelet radiol 12(3):223–237

    Article  PubMed  Google Scholar 

  • Barth MM, Smith MP, Pedrosa I, Lenkinski RE, Rofsky NM (2007) Body MR imaging at 3.0 T: understanding the opportunities and challenges. Radiographics 27(5):1445–1462 discussion 1462–1444

    Article  PubMed  Google Scholar 

  • Blackband SJ, Chakrabarti I, Gibbs P, Buckley DL, Horsman A (1994) Fingers: three-dimensional MR imaging and angiography with a local gradient coil. Radiology 190(3):895–899

    PubMed  CAS  Google Scholar 

  • Breitenseher MJ, Metz VM, Gilula LA, Gaebler C, Kukla C, Fleischmann D et al (1997) Radiographically occult scaphoid fractures: value of MR imaging in detection. Radiology 203(1):245–250

    PubMed  CAS  Google Scholar 

  • Brown JA, Janzen DL, Adler BD, Stothers K, Favero KJ, Gropper PT et al (1994) Arthrography of the contralateral, asymptomatic wrist in patients with unilateral wrist pain. Can Assoc Radiol J 45(4):292–296

    PubMed  CAS  Google Scholar 

  • Burns JE, Tanaka T, Ueno T, Nakamura T, Yoshioka H (2011) Pitfalls that may mimic injuries of the triangular fibrocartilage and proximal intrinsic wrist ligaments at MR imaging. Radiographics : a review publication of the Radiological Society of North America 31(1):63–78

    Article  Google Scholar 

  • Cantor RM, Stern PJ, Wyrick JD, Michaels SE (1994) The relevance of ligament tears or perforations in the diagnosis of wrist pain: an arthrographic study. J Hand Surg 19(6):945–953

    Article  CAS  Google Scholar 

  • Cerezal L, Abascal F, Garcia-Valtuille R, Del Pinal F (2005) Wrist MR arthrography: how, why, when. Radiologic clin N Am 43(4):709–731

    Article  Google Scholar 

  • Farooki S, Ashman CJ, Yu JS, Abduljalil A, Chakeres D (2002) In vivo high-resolution MR imaging of the carpal tunnel at 8.0 tesla. Skeletal Radiol 31(8):445–450

    Article  PubMed  Google Scholar 

  • Gold GE, McCauley TR, Gray ML, Disler DG (2003) What’s new in cartilage? Radiographics : a review publication of the Radiological Society of North America 23(5):1227–1242

    Article  Google Scholar 

  • Haims AH, Moore AE, Schweitzer ME, Morrison WB, Deely D, Culp RW et al (2004) MRI in the diagnosis of cartilage injury in the wrist. AJR Am J Roentgenol 182(5):1267–1270

    Article  PubMed  Google Scholar 

  • Haims AH, Schweitzer ME, Morrison WB, Deely D, Lange RC, Osterman AL et al (2003) Internal derangement of the wrist: indirect MR arthrography versus unenhanced MR imaging. Radiology 227(3):701–707

    Article  PubMed  Google Scholar 

  • Hauger O, Chung CB, Lektrakul N, Botte MJ, Trudell D, Boutin RD et al (2000) Pulley system in the fingers: normal anatomy and simulated lesions in cadavers at MR imaging, CT, and US with and without contrast material distention of the tendon sheath. Radiology 217(1):201–212

    PubMed  CAS  Google Scholar 

  • Hunter JC, Escobedo EM, Wilson AJ, Hanel DP, Zink-Brody GC, Mann FA (1997) MR imaging of clinically suspected scaphoid fractures. AJR Am J Roentgenol 168(5):1287–1293

    Article  PubMed  CAS  Google Scholar 

  • Kessler I, Silberman Z (1961) An experimental study of the radiocarpal joint by arthrography. Surg Gynecol Obstet 112:33–40

    PubMed  CAS  Google Scholar 

  • Kocharian A, Adkins MC, Amrami KK, McGee KP, Rouleau PA, Wenger DE et al (2002) Wrist: improved MR imaging with optimized transmit-receive coil design. Radiology 223(3):870–876

    Article  PubMed  Google Scholar 

  • Levinsohn EM, Palmer AK, Coren AB, Zinberg E (1987) Wrist arthrography: the value of the three compartment injection technique. Skeletal Radiol 16(7):539–544

    Article  PubMed  CAS  Google Scholar 

  • Levinsohn EM, Rosen ID, Palmer AK (1991) Wrist arthrography: value of the three-compartment injection method. Radiology 179(1):231–239

    PubMed  CAS  Google Scholar 

  • Magee T (2009) Comparison of 3-T MRI and arthroscopy of intrinsic wrist ligament and TFCC tears. AJR Am J Roentgenol 192(1):80–85

    Article  PubMed  Google Scholar 

  • Malfair D (2008) Therapeutic and diagnostic joint injections. Radiologic Clin N Am 46(3):439–453

    Article  Google Scholar 

  • Manaster BJ (1991) The clinical efficacy of triple-injection wrist arthrography. Radiology 178(1):267–270

    PubMed  CAS  Google Scholar 

  • Medverd JR, Pugsley JM, Harley JD, Bhargava P (2011) Lateral approach for radiocarpal wrist arthrography. AJR Am J Roentgenol 196(1):W58–W60

    Article  PubMed  Google Scholar 

  • Moser T, Dosch JC, Moussaoui A, Dietemann JL (2007) Wrist ligament tears: evaluation of MRI and combined MDCT and MR arthrography. AJR Am J Roentgenol 188(5):1278–1286

    Article  PubMed  Google Scholar 

  • Mutimer J, Green J, Field J (2008) Comparison of MRI and wrist arthroscopy for assessment of wrist cartilage. J Hand Surg 33(3):380–382

    CAS  Google Scholar 

  • Nakamura T, Yabe Y, Horiuchi Y (1996) Functional anatomy of the triangular fibrocartilage complex. J Hand Surg 21(5):581–586

    CAS  Google Scholar 

  • Omlor G, Jung M, Grieser T, Ludwig K (2009) Depiction of the triangular fibro-cartilage in patients with ulnar-sided wrist pain: comparison of direct multi-slice CT arthrography and direct MR arthrography. Eur Radiol 19(1):147–151

    Article  PubMed  Google Scholar 

  • Potter HG, Asnis-Ernberg L, Weiland AJ, Hotchkiss RN, Peterson MG, McCormack RR Jr (1997) The utility of high-resolution magnetic resonance imaging in the evaluation of the triangular fibrocartilage complex of the wrist. J Bone Joint Surg 79(11):1675–1684

    PubMed  CAS  Google Scholar 

  • Roemer PB, Edelstein WA, Hayes CE, Souza SP, Mueller OM (1990) The NMR phased array. MRM: official journal of the society of magnetic resonance in medicine/society of magnetic resonance in medicine 16(2):192–225

    Article  CAS  Google Scholar 

  • Ruegger C, Schmid MR, Pfirrmann CW, Nagy L, Gilula LA, Zanetti M (2007) Peripheral tear of the triangular fibrocartilage: depiction with MR arthrography of the distal radioulnar joint. AJR Am J Roentgenol 188(1):187–192

    Article  PubMed  Google Scholar 

  • Saupe N, Prussmann KP, Luechinger R, Bosiger P, Marincek B, Weishaupt D (2005) MR imaging of the wrist: comparison between 1.5- and 3-T MR imaging–preliminary experience. Radiology 234(1):256–264

    Article  PubMed  Google Scholar 

  • Schmid MR, Schertler T, Pfirrmann CW, Saupe N, Manestar M, Wildermuth S et al (2005) Interosseous ligament tears of the wrist: comparison of multi-detector row CT arthrography and MR imaging. Radiology 237(3):1008–1013

    Article  PubMed  Google Scholar 

  • Stevens KJ, Wallace CG, Chen W, Rosenberg JK, Gold GE (2011) Imaging of the wrist at 1.5 Tesla using isotropic three-dimensional fast spin echo cube. JMRI 33(4):908–915

    Article  PubMed  Google Scholar 

  • Tan AL, Grainger AJ, Tanner SF, Shelley DM, Pease C, Emery P et al (2005) High-resolution magnetic resonance imaging for the assessment of hand osteoarthritis. Arthritis Rheum 52(8):2355–2365

    Article  PubMed  Google Scholar 

  • Theumann NH, Pfirrmann CW, Antonio GE, Chung CB, Gilula LA, Trudell DJ et al (2003) Extrinsic carpal ligaments: normal MR arthrographic appearance in cadavers. Radiology 226(1):171–179

    Article  PubMed  Google Scholar 

  • Wilson AJ, Gilula LA, Mann FA (1991) Unidirectional joint communications in wrist arthrography: an evaluation of 250 cases. AJR Am J Roentgenol 157(1):105–109

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Royal United Hospital, Bath, UK

    Emma L. Rowbotham

  2. Department of Musculoskeletal Radiology, Chapel Allerton Orthopaedic Centre, Leeds, LS7 4SA, UK

    Andrew J. Grainger

Authors
  1. Emma L. Rowbotham
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  2. Andrew J. Grainger
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Corresponding author

Correspondence to Emma L. Rowbotham .

Editor information

Editors and Affiliations

  1. Royal Orthopaedic Hospital, MRI Centre, NHS Foundation Trust, Bristol Road South, Birmingham, B31 2AP, United Kingdom

    A. Mark Davies

  2. Chapel Allerton Hospital, Department of Radiology, Leeds Teaching Hospitals, Chapel Town Road, Leeds, LS4 7SA, United Kingdom

    Andrew J. Grainger

  3. Royal Orthopaedic Hospital, Bristol Road South, Birmingham, B31 2AP, United Kingdom

    Steven J. James

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© 2013 Springer-Verlag Berlin Heidelberg

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Rowbotham, E.L., Grainger, A.J. (2013). MRI and MR Arthrography. In: Davies, A., Grainger, A., James, S. (eds) Imaging of the Hand and Wrist. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2012_700

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  • DOI: https://doi.org/10.1007/174_2012_700

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-11143-3

  • Online ISBN: 978-3-642-11146-4

  • eBook Packages: MedicineMedicine (R0)

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