Radiology of the hand

The neutral position is crucial for correct image interpretation of wrist radiographs in two planes. See how the neutral views are correctly acquired and checked with characteristics.

Two additional radiographs of the wrist are important for detecting injuries, namely the stress radiograph in the ball grip and the Stecher view. See how these are performed.

Fractures, dislocations, and osteoarthritis are common at the midhand and fingers as well as in the metacarpophalangeal and interphalangeal joints. Precise radiographs are essential.

Radiographs of the whole hand are taken in the diagnostics of severe hand injuries, inflammatory systemic diseases, and in congenital malformations. Three views are often used.

Indications for carpal arthrography are the scapholunate and lunotriquetral dissociations, lesions of the foveal lamina of the TFCC and initial stages of chondropathy.

Although often underestimated by radiologists, high-frequency ultrasound plays an important role in the assessment of pathologies of the soft-tissues.

The scan volume should be kept to a minimum in CT diagnostics in order to fulfil radiation protection guidelines and to limit the number of images.

Standardized slice reconstructions from the three-dimensional CT data set are important for image interpretation and reproducibility in follow-up studies.

The scaphoid has a special position on the wrist because it is orientated at angles of approx. 45 degrees relative to the coronal and sagittal planes. This is relevant in CT imaging.

CT arthrography is a sensitive method for detecting intra-articular pathologies (scapholunate / lunotriquetral dissociation, TFCC lesion, chonodropathy).

In to obtain a high spatial resolution in a reasonable examination time, the field of view (FoV) and the number of sequences must be kept small in MR imaging.

Unlike the often-unenhanced examinations, in our opinion it is essential to perform MRI of the hand with the use of contrast agent (intravenous, intra-articular).