Sports Imaging

Hand and Wrist Injuries.

Fractures of the wrist can be subtle and often go undetected on routine X-Rays and sometimes even CT. MRI detects fractures with almost 100% accuracy, including small areas of  “bone bruising” where microscopic fractures are present.

Detection of such injuries in the professional athletes is paramount, so that treatment may be instituted rapidly and without delay in obtaining an accurate diagnosis. Of note, it is critical to confirm whether the fracture of the scaphoid exists or not.

Overuse injuries typically involve tendons and their sheaths, resulting in tendinosis and tenosynovitis respectively. Common diagnoses include de Quervain’s tenosynovitis, which is an inflamed first extensor tendon sheath of the wrist and responds well to ultrasound guided cortisone injections.

Case examples:

1.

Fracture of the radius

MRI of the wrist confirms the presence of a non displaced fracture of the radius (arrow).

2.

Sprain injury

MRI of the wrist performed on an athlete with long standing wrist pain and normal X-Rays following a fall shows hyperintense (bright) ligaments consistent with previous sprain injury.

3.

Wrist CT

Multidetector CT volume rendered images of the wrist provides an overall three dimensional overview of the wrist.

4.

Wrist CT - Scaphoid fracture

CT imaging demonstrates a horizontally orientated fracture through the scaphoid.