Learning objectives
To review the normal ultra-sonographic anatomy of the wrist joint,
using didactic schemes and iconographic examples
To describe the proper scanning technique and specific exam objectives.
Background
Ultrasound (US) has unique characteristics that make it very useful in the assessment of the musculoskeletal system,
namely good spatial resolution,
allowing immediate clinical correlation and dynamic assessment.
A more widespread access to high resolution ultrasound probes has raised interest in its application to smaller structures such as those present in the wrist.
In order to maximize the accuracy of wrist US,
radiologists must be comfortable with the complex anatomy of this joint,
with the more common clinical complaints and with the adequate examination technique....
Findings and procedure details
1. Technique and normal structures
In routine US examinations of the wrist,
the patient should be sitting down,
with both hands and elbows placed on the examination table.
A high frequency transducer must be used (at least 12 MHz),
as most evaluated structures are superficial.
A normal examination of the wrist begins with the assessment of the dorsal aspect followed by the ventral aspect of the wrist.
The scanning of the contralateral wrist is often useful to detect asymmetries between normal and pathological wrists.
Normal...
Conclusion
Ultrasound imaging of the wrist provides an important,
safe,
and accessible diagnostic tool for the radiologist.
This inexpensive,
fast and readily accessible modality can accurately assess the wrist joint whilst allowing guided intervention.
Comprehensive anatomical and musculoskeletal ultrasound knowledge together with a standardized imaging technique is crucial for obtaining high diagnostic accuracies with this technique.
References
Justin C.
L.,
et al.
Normal sonographic anatomy of the wrist and hand.
RadioGraphics 2005; 25: 1577–1590.
Bianchi S,
Martinoli C.
Wrist.
Ultrasound of the musculoskeletal system.
NewYork,
NY: Springer,
2007.
Jacobson J.A.
Fundamentals of musculoskeletal ultrasound.
Philadelphia,
Pa: Saunders Elsevier,
2007.
Daniels,
J.
M.
Wrist.
Basics of musculoskeletal ultrasound.
Springer,
2013.
Beggs I,
Bianchi S,
Bueno A,
Cohen M,
Court-Payen M,
Grainger A,
Kainberger F,
Klauser A,
Martinoli C,
McNally E,
O'Connor PJ,
Peetrons P,
Reijnierse M,
Remplik P,
Silvestri E.
Musculoskeletal Ultrasound Technical...