1. Imaging of Wrist
DR AMITA HARSULE

2. Basic Radiograph ROUTINE ■ PA ■ Lateral
■ Scaphoid series – when there is tenderness in the anatomical snuff box.

4. PA ulnar deviation

13. note the disruption of arc I at the lunotriquetral joint.

14. A disruption of the second carpal arc at the scapholunate joint and the lunotriquetral joint is seen on the left.

15. There is an abnormal step off at the capitohamate joint.

18. Volar aspect of the wrist

19. USG

21. CT

22. CT

25. Ligamentous Anatomy Classified as either extrinsic or intrinsic.
The extrinsic ligaments link the carpal bones to the radius and ulna.
The intrinsic or intercarpal ligaments connect the individual carpal bones.

27. Normal TFCC. Triangular fibrocartilage proper (*).
Foveal (arrow) and styloid (dashed arrow) insertions.
Meniscus homologue (arrow head).
Normal lunotriquetral (LTL) and scapholunate (SLL) ligaments are also seen.

28. MENISCUS HOMOLOGUE

34. Tendon pathology
Tendon pathology is often encountered in the wrist and hand, which may be the result of overuse, trauma or inflammation. Patients typically present with focal pain and swelling.
The term "tendinitis" is an inaccurate term
A better term is tendinosis, which describes a degenerative process with "microtears", healing and vascular in-growth.
The term "tendinopathy" encompasses both degenerative and inflammatory conditions.
Tenosynovitis refers to inflammatory change within the tendon sheath, with or without tendon morphological changes.

35. flexor tenosynovitis

40. Carpal Tunnel $
Causes include flexor tenosynovitis, trauma, systemic inflammatory disease, pregnancy, acromegaby, hypothyroidism

41. Space-occupying lesions within the carpal tunnel such as ganglia, tenosynovitis, and anatomic variants are well seen with MR imaging
MR imaging is therefore indicated only in patients with equivocal clinical findings, a suspected mass

47. Compressive ulnar neuropathy.
At the level of the canal of Guyon’s.
The Guyon canal is a triangular space lateral to the pisiform bone and medial to the hamate that contains the ulnar nerve and ulnar artery.
The ulnar nerve (arrow) has high signal intensity and it is thickened. There is a ganglion cyst (*) compressing the ulnar nerve against the pisiform.

48. GANGUON CYSTS
Seventy percent of all wrist ganglia occur dorsally adjacent to the SLL

49. 1. ganglion cyst that arises from the dorsal aspect of the SLL
2. volar ganglion cyst adjacent to the radioscaphoid joint

50. schwannoma of radial nerve

51. THANK YOU