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Merrill C. Sosman Lecture. MR imaging of the wrist.

Imaging of the wrist should always begin with a plain film examination. Sonography and tenography are sometimes used to evaluate tendon abnormalities. Sonography is operator dependent; tenography, because of its invasive nature, is rarely used today. Arthrography, with single or triple injection techniques, with [1] or without [2] digital subtraction, has been the procedure of choice for detecting abnormalities of the interosseous ligaments and the triangular fibrocartilage (TFC). MR imaging is the only imaging technique that can directly depict the interosseous ligaments and the TFC. It is the imaging technique of choice for the early diagnosis of aseptic necrosis, for tumor staging, and for evaluating soft-tissue masses. MR imaging enables noninvasive global examination of the wrist that is extremely sensitive in detecting osseous and soft-tissue disease. Because technical advances will allow more rapid data acquisition, thinner slices, and higher resolution, I predict MR imaging will replace arthrography in the near future.