TRAUMA OF THE WRIST

In wrist injury, plain radiographs form the basis of diagnostic imagin g, and can provide definitive answers in most cases. MR imaging is the method of choice for several diagnostic problem cases. These problems can include radiographically occult fractures where MRI enables early diagnosis compared to follow-up radiographs. Early stage diagnosis of a post-traumatic avascular osteonecrosis with high sensitivity and sp ecificity, is only possible with MRI. In these instances, radiographs are only sensitive in later stages and scintigraphy is quite nonspecif ic. Stress fractures, invisible with other modalities, are also demons trable with MRI. In addition, MRI is helpful in special circumstances with regard to non-union or pseudarthrosis. In wrist instability, radi ographs in combination with stress views and fluoroscopy are still the initial diagnostic step. MRI, with the advantage of direct Visualizat ion of the wrist ligaments and triangular fibrocartilage complex, offe rs very promising results in this area. Generally, for the evaluation of wrist injury, MRI can be considered the most important second-step procedure in patients where radiographs are nondiagnostic. (C) 1997 El sevier Science Ireland Ltd.