ROLE OF MAGNETIC RESONANCE IMAGING IN EVALUATION OF PAINFUL WRIST

Abstract

Painful wrist is a common manifestation that has a variety of bone and soft tissue causes. The. bony causes of painful wrist include occult fractures of the carpal bones, avascular necrosis of the carpal bones and bone tumours. The soft tissue lesions include carpal ligaments tears, nerve entrapment syndrome, tendons and synovial abnormalities, and soft tissue tumours. Evaluation of wrist pain begins with a review of findings from medical history, a detailed physical examination, and plain radiography. If a diagnosis is not forthcoming, additional diagnostic studies may be obtained, including special radiographs, arthrograms, computed tomography, isotope scans, arthroscopy and magnetic resonance 1magmg. Magnetic resonance image is an effective method in determining the cause of the wrist pain by demonstrating a broad spectrum of abnormalities, including those of bone, cartilage, ligaments and tendons. In our study (26) cases were examined by MRI to establish the optimal technique of MRI examination of the wrist, detect the cause of painful wrist, and to select the ideal indication of MRI in cases of painful wrist. The results of this study include 6 cases had AVN of the carpal bones, 4 cases had occult fracture of the scaphoid, 7 cases had carpal ligaments tears, 4 cases had wrist masses, 3 cases had carpal tunnel syndrome and 2 cases had synovial lesions.