Wrist & Elbow MRI: TFCC, Scaphoid & Ligament Injuries
Small joints, high stakes. A missed scaphoid fracture or ligament tear has real consequences, and MRI is often what settles it.
Wrist
- Occult scaphoid fracture: clinically suspected but X-ray-negative. MRI detects the fracture line/marrow oedema early, avoiding both missed fractures and unnecessary casting.
- TFCC: triangular fibrocartilage complex tears causing ulnar-sided pain.
- Intrinsic ligaments: scapholunate and lunotriquetral tears (causes of instability).
- AVN: Kienböck’s (lunate) and scaphoid proximal-pole osteonecrosis.
MR arthrography improves detection of TFCC and intrinsic ligament tears when a high-grade injury is suspected.
Elbow
- Epicondylitis: common extensor (“tennis elbow”) and common flexor (“golfer’s”) tendinosis/tears.
- Ligaments: ulnar collateral ligament (UCL) injury, important in throwing athletes.
- Tendons: distal biceps and triceps tears.
- Other: osteochondritis dissecans of the capitellum, loose bodies, nerve entrapment.
Practical notes
Positioning affects quality (superman vs by-the-side); high-resolution surface coils and thin slices are needed for these small structures. Correlate with the exact site of clinical pain.
Sources
- Zanetti M, Saupe N. MR imaging of the wrist and elbow (clinical practice reviews).
Educational summary for clinicians; correlate with exam. Not medical advice.
Contents