Diagnostic Imaging for Dorsal Wrist Pain

Imaging Recommendations

• MRI is the recommended next study for patients with dorsal wrist pain when radiographs are normal or nonspecific, as recommended by the American College of Radiology 1, 2
• MRI accurately depicts abnormalities of bones, bone marrow, articular cartilage, intrinsic and extrinsic ligaments, TFCC, synovium, tendons, and neurovascular structures, according to the American College of Radiology 3
• For patients with persistent pain despite conservative management, consider advanced imaging with MR arthrography or CT arthrography, which may reveal additional details about ligament tears, as suggested by the American College of Radiology 1, 2
• Direct MR arthrography has higher sensitivity than non-contrast-enhanced MRI for diagnosis of complete and incomplete scapholunate and lunotriquetral ligament tears, as reported by the American College of Radiology 4
• CT arthrography may be more sensitive for tears of the biomechanically important dorsal ligament fibers compared to conventional MRI, according to the American College of Radiology 4