3 Diagnostic imaging of the hand and wrist
Synopsis
Introduction
• A proper and directed history-taking followed by a careful examination of both hands and wrists forms the foundation of a clinical differential diagnosis in hand conditions.
• Appropriate investigations are then ordered to help confirm the clinical diagnosis.
• Diagnostic imaging modalities are often the first-line investigations ordered, as many clinical conditions in the hand and wrist can be seen visually.
• Technological advances in many advanced imaging modalities like ultrasound, CT, and MRI, has led to them being applied for use in the hand and wrist. This increases clinician choices for diagnostic imaging of a suspected clinical condition.
• The radiograph, despite its simplicity and age, still forms the foundation of imaging of hand and wrist conditions. In many clinical situations, an appropriately chosen and well-taken set of radiographs may be all the diagnostic imaging required.
• The key to obtaining the most information from a radiograph is to understand which radiographs are appropriate for each clinical situation, and how to obtain good-quality radiographs for evaluation.
• Advanced imaging modalities may then be ordered to provide additional information for decision-making.
• This chapter will equip the reader with practical information about the different imaging modalities available for the hand and wrist.
• It will start from the foundation of radiographs, covering the appropriate views, how they are taken, and how best to evaluate them. From this foundation, the advanced imaging techniques will be described in turn, emphasizing their applications in the hand and wrist.
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