Presentation2.pptx wrist joint.

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MRI of the wrist joint. DR/ ABD ALLAH NAZEER. MD.

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Transcript of Presentation2.pptx wrist joint.

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MRI of the wrist joint.

DR/ ABD ALLAH NAZEER. MD.

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1. Acute and chronic wrist instability.2. Dorsal or ulnar-sided wrist pain. 3. Wrist symptoms in adolescent gymnasts and other

athletes.4. Unexplained chronic wrist pain.5. Acute wrist trauma.6. Avascular necrosis.7. Wrist malalignments.8. Limited or painful range of motion.9. Unexplained wrist swelling, mass, or atrophy.10. Planning for diagnostic or therapeutic arthroscopy.11. Recurrent, residual, or new symptoms following wrist surgery.

Indications for MRI of the wrist joint.

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Subchondral erosion of lunate

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Scaphoid waist fracture with subtle collapse of the proximal pole, related AVN .

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Kienböck's Disease.

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Kienböck's Disease.

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Capitate avascular necrosis.

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DISI deformity

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DISI deformity.

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Scapho - lunate ligament tear

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Scapholunate and lunotriquetral ligament tear

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1. Scapholunate ligament tear, dorsal angulation of the lunate and proximal migration of the capitate consistent with a DISI deformity.2. Tear of the lunotriquetral and triscaphe ligaments.

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Triangular fibrocartilage complex tear.

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Ulnar variance may be :neutral (both the ulnar and radial articular surfaces at the same level)positive (ulna projects more distally)negative (ulna projects more proximally)

Causes trauma or mechanical

distal radius/ulnar fractures with shortening (e.g. impaction) & angulationDRUJ ligamentous injuries (e.g. Galeazzi & Essex-Lopresti)surgical shortening of ulna or radiusgrowth arrest (e.g. previous Salter-Harris fracture)

congenital Madelung deformity/reverse Madelung deformity

Associationspositive ulnar variance is associated with ulnar impaction syndrome.negative ulnar variance is associated with Kienbock disease and ulnar impingement syndrome

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Positive ulnar variance secondary to TFC tear.

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Swelling , deformity , abnormal signal

of the median nerve

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Lipoma of the carpal tunnel.

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Carpal tunnel syndrome caused by cysticercosis

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Ganglion cyst.

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TenosynovitisTenosynovitis is an inflammation of the tendon, either primary or

secondary.

Marked inflammatory tenosynovitis.

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Tenosynvitis of abductor pollicis longus (APL) and extensor pollicis longus (EPL).

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Tenosynovitis of the flexor tendons.

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Tenosynovitis of all flexor tendons

FDS, FDP, FPL

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Tenosynovitis with partial tears of the EPL, ECRB and ECRL

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