To outline the standard procedure of 3-compartment wrist arthrogram. To review the normal fluoroscopic and MRI findings. To depict examples of injuries, including scapholunate tear, TFCC tear, non-communicating TFC tear, unidirectional tear.

The wrist joint is complex with multiple ligaments and articular joints. Ligaments can be injured in trauma or as degenerative tears. The most commonly implicated injuries can involve the scapholunate ligament, lunotriquetral ligament and trianguar fibrocartilaginous complex (TFCC). If overlooked, ligamentous injuries can lead to progressive instability. The wrist joint can be thought simplistically as being composed of three major compartments (Figure 1): 1) distal radioulnar joint (DRUJ) 2) radiocarpal compartment 3) midcarpal compartment The proximal carpal row bones are connected by the scapholunate and...

Procedure We hereby present ourstandard local department procedure in performing the 3-compartment wrist arthrogram. Step 1a (Figure 2) The procedure begins with fluoroscopy, where the dorsum of the wrist is prepared using an aseptic technique. The midcarpal compartment is punctured, and iodinated contrast is injected. Adequate distension can usually be achieved with 2 mL of contrast. Step 1b (Video clip in Fig. 3 and Fig. 4), (Figure 5) Under live fluoroscopy (video clips in Fig. 3 and Fig. 4), the wrist is manipulated to allow...

3-compartment wrist MR arthrography is a powerful tool and increases diagnostic certainty over standard MR in assessing for ligamentous tears. Unidirectional tears, whilst rare, can be diagnosed readily with direct MR arthrography as it utilises both iodinated and MR contrast.

Moser T, Dosch JC, Moussaoui A, Buy X, Gangi A, Dietemann JL. Multidetector CT arthrography of the wrist joint: how to do it. Radiographics. 2008 May-Jun;28(3):787-800.

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