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Magnetic Resonance Imaging of the Hand and Wrist: Techniques and Spectrum of Disease by Ashvin K. Dewan, A. Bobby Chhabra, A. Jay Khanna, Mark W. Anderson,

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Presentation on theme: "Magnetic Resonance Imaging of the Hand and Wrist: Techniques and Spectrum of Disease by Ashvin K. Dewan, A. Bobby Chhabra, A. Jay Khanna, Mark W. Anderson,"— Presentation transcript:

1 Magnetic Resonance Imaging of the Hand and Wrist: Techniques and Spectrum of Disease by Ashvin K. Dewan, A. Bobby Chhabra, A. Jay Khanna, Mark W. Anderson, and Lance M. Brunton J Bone Joint Surg Am Volume 95(10):e68 May 15, 2013 ©2013 by The Journal of Bone and Joint Surgery, Inc.

2 Ashvin K. Dewan et al. J Bone Joint Surg Am 2013;95:e68 ©2013 by The Journal of Bone and Joint Surgery, Inc.

3 Ashvin K. Dewan et al. J Bone Joint Surg Am 2013;95:e68 ©2013 by The Journal of Bone and Joint Surgery, Inc.

4 Ashvin K. Dewan et al. J Bone Joint Surg Am 2013;95:e68 ©2013 by The Journal of Bone and Joint Surgery, Inc.

5 Sagittal STIR image of the wrist showing widening of the distal radial physis (arrow) and diffuse marrow edema in the distal radial metaphysis, compatible with epiphysiolysis (“gymnast’s wrist”). Ashvin K. Dewan et al. J Bone Joint Surg Am 2013;95:e68 ©2013 by The Journal of Bone and Joint Surgery, Inc.

6 Coronal gradient-echo image showing ulnar positive variance, a large defect in the central portion of the triangular fibrocartilage complex (arrows), and loss of articular cartilage along the proximal aspect of the lunate (arrowhead). Ashvin K. Dewan et al. J Bone Joint Surg Am 2013;95:e68 ©2013 by The Journal of Bone and Joint Surgery, Inc.

7 Coronal fat-suppressed T1-weighted image from an MR arthrogram (radiocarpal injection) showing a partial tear of the peripheral portion of the triangular fibrocartilage complex near its ulnar attachment (arrow) and abnormal extension of contrast agent into... Ashvin K. Dewan et al. J Bone Joint Surg Am 2013;95:e68 ©2013 by The Journal of Bone and Joint Surgery, Inc.

8 Fig. 5 Coronal gradient-echo image of the wrist showing foci of amorphous, intermediate signal intensity within the intact scapholunate and lunotriquetral ligaments (arrows), representing a normal variation. Ashvin K. Dewan et al. J Bone Joint Surg Am 2013;95:e68 ©2013 by The Journal of Bone and Joint Surgery, Inc.

9 Fig. 6 Coronal gradient-echo image of the wrist showing a small perforation in the membranous portion of the scapholunate ligament (arrow). Ashvin K. Dewan et al. J Bone Joint Surg Am 2013;95:e68 ©2013 by The Journal of Bone and Joint Surgery, Inc.

10 Coronal oblique T2-weighted image of the thumb showing a complete rupture of the ulnar collateral ligament at the metacarpophalangeal joint with high-signal-intensity fluid between the margins of the torn ligament (arrow). Ashvin K. Dewan et al. J Bone Joint Surg Am 2013;95:e68 ©2013 by The Journal of Bone and Joint Surgery, Inc.

11 Coronal gradient-echo image of the wrist showing a complete rupture of the flexor carpi radialis tendon with thickening and diffusely abnormal signal at its torn margin (arrow). Ashvin K. Dewan et al. J Bone Joint Surg Am 2013;95:e68 ©2013 by The Journal of Bone and Joint Surgery, Inc.

12 Coronal STIR image of the wrist showing focal marrow edema within the proximal ulnar aspect of the lunate (large arrow) and a large defect within the triangular fibrocartilage complex (small arrows), findings that are consistent with ulnar impaction syndrome. Ashvin K. Dewan et al. J Bone Joint Surg Am 2013;95:e68 ©2013 by The Journal of Bone and Joint Surgery, Inc.

13 Axial fat-suppressed T2-weighted image showing high-signal-intensity fluid distending the sheath of the first extensor compartment, with thickening of the abductor pollicis longus and extensor pollicis brevis tendons (arrow) compatible with de Quervain teno... Ashvin K. Dewan et al. J Bone Joint Surg Am 2013;95:e68 ©2013 by The Journal of Bone and Joint Surgery, Inc.

14 Coronal T1-weighted image showing diffusely mottled, decreased marrow signal intensity throughout the lunate, indicating osteonecrosis (Kienböck disease). Ashvin K. Dewan et al. J Bone Joint Surg Am 2013;95:e68 ©2013 by The Journal of Bone and Joint Surgery, Inc.

15 Coronal T1-weighted image showing loss of marrow signal intensity within the proximal pole of the scaphoid after a fracture (arrow), indicative of post-traumatic osteonecrosis. Ashvin K. Dewan et al. J Bone Joint Surg Am 2013;95:e68 ©2013 by The Journal of Bone and Joint Surgery, Inc.

16 Coronal fat-suppressed, post-gadolinium T1-weighted image showing diffuse high signal enhancement (arrow) involving the metacarpophalangeal joints, consistent with synovitis due to early rheumatoid arthritis; conventional radiographs were normal. Ashvin K. Dewan et al. J Bone Joint Surg Am 2013;95:e68 ©2013 by The Journal of Bone and Joint Surgery, Inc.

17 Axial T1-weighted image at the level of the carpal tunnel showing postoperative scarring in the subcutaneous fat (large white arrow) after carpal tunnel release. Ashvin K. Dewan et al. J Bone Joint Surg Am 2013;95:e68 ©2013 by The Journal of Bone and Joint Surgery, Inc.

18 Ulnar tunnel syndrome. Ashvin K. Dewan et al. J Bone Joint Surg Am 2013;95:e68 ©2013 by The Journal of Bone and Joint Surgery, Inc.

19 Giant cell tumor of the tendon sheath. Ashvin K. Dewan et al. J Bone Joint Surg Am 2013;95:e68 ©2013 by The Journal of Bone and Joint Surgery, Inc.


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