RadteraMRI Wrist Without Contrast
MRNo contrastMSK
Indications
- Wrist pain
- TFCC tear
- Scapholunate/lunotriquetral ligament injury
- Occult scaphoid fracture
- Avascular necrosis (scaphoid/lunate-Kienbock)
- Ganglion / mass
- Carpal tunnel syndrome
Patient prep
- MRI safety screening
- Wrist coil
- Arm at side or overhead ('superman') in dedicated wrist coil; minimize motion
Contrast
None / non-contrast
Technique
- Small FOV (~8-10 cm) high-resolution imaging of carpus
- Thin slices 2-3 mm; high in-plane resolution for ligaments/TFCC
- Coronal is primary plane for intrinsic ligaments and TFCC
- Consider MR arthrography for ligament/TFCC tears
Series / Sequences
| # | Series / Sequence | Plane | Weighting / Recon | Thickness | Notes |
|---|---|---|---|---|---|
| 1 | Cor T1 or PD | coronal | T1/PD | 2-3 mm | Carpal bones, ligaments, AVN |
| 2 | Cor T2 fat-sat (or STIR) | coronal | T2 FS | 2-3 mm | TFCC, SL/LT ligaments, edema |
| 3 | Ax PD/T2 fat-sat | axial | PD/T2 FS | 2-3 mm | Carpal tunnel, tendons, DRUJ |
| 4 | Cor 3D GRE (optional) | coronal | T2* GRE | 0.5-1 mm | High-res cartilage/ligament |
| 5 | Sag PD/T2 (targeted) | sagittal | PD/T2 | 2-3 mm | DISI/VISI alignment, lunate |
Key points
- High spatial resolution essential—use smallest FOV and dedicated coil.
- Coronal fat-sat best for TFCC and intrinsic ligaments; AVN seen as T1 low marrow signal.
- MR arthrography increases sensitivity for partial ligament/TFCC tears.
- Occult scaphoid fracture: T1 low + STIR high marrow signal.
References
• ACR-SSR Practice Parameter for MRI of the Wrist
• Radiopaedia: Wrist MRI protocol link
• ACR Appropriateness Criteria: Chronic Wrist Pain
• Radiopaedia: Wrist MRI protocol link
• ACR Appropriateness Criteria: Chronic Wrist Pain
Source: Researched — verify against your institution
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.