Wrist Pain: Identifying Pathologies in Tiny Structures with High Resolution MRI

Carpal Tunnel SyndromeMR imaging aids evaluation of a number of abnormalities of the bones, ligaments, and soft tissues in the wrist. These include ligamentous disruption, disorders of the triangular fibrocartilage, ulnar impaction sydrome, damage to articular cartilage, distal radioulnar joint instability, fracture, avascular necrosis, tendinopathy, nerve entrapment syndromes, synovial abnormalities, and soft-tissue masses.

Ligamentous Disruption and Carpal Instability

• Proximal intercarpal liga­ments. The scapho­lunate and luno­triquetral liga­ments are important for carpal stability. These ligaments bridge the dorsal, prox­imal, and…

• Extrinsic liga­ments. MRI may pro­vide an alternative to wrist arthroscopy for eval­uation of extrinsic ligament injury. Most of the extrinsic liga­ments abut the…

Disorders of Triangular Fibrocartilage

The triangular fibrocartilage is an important structure that cushions the ulnocarpal artic­ulation and stabilizes the distal..

Ulnar Impaction Syndrome

The distribution of forces transmitted across the wrist through the radius and ulna is associated with the relative…


Cartilage lesions can result from trauma or arthritis and are often…3


MR imaging can be used for detecting subtle or occult fractures in selected problem cases. It can also rule out fractures in a much larger proportion of patients who would otherwise…

Avascular Necrosis

MR imaging is useful for identifying early carpal bone avascular necrosis during the evaluation of…

• Kienböck’s disease. Also known as luna­tomalacia, Kienböck’s disease refers to avascular…


The extensor tendons of the wrist are divided into six compartments that overlie the…Kienbock's Disease

Nerve Entrapment Syndromes

• Carpal tunnel syndrome. The anatomic causes of median nerve compression in the carpal tunnel can be assessed by…

• Guyon’s canal syndrome. The deep motor branch of the ulnar nerve is subject to compression by…

Soft-Tissue Masses

Common benign soft-tissue tumors of the wrist include ganglion, lipoma, neural tumor, and hemangioma. Epi­thelioid sarcoma is an ominous…


This article was edited from MR Imaging in Wrist Pain by the same author. The complete unabridged version, including all of its images and references, is available at the Apple iBooks Store. See our other MSK and joint articles here.



  1. Ringler MD, Murthy NS. MR Imaging of Wrist Ligaments. Magn Reson Imaging Clin N Am. 2015 Aug;23(3):367-91
  2. Cody ME, Nakamura DT, Small KM, Yoshioka H. MR Imaging of the Triangular Fibrocartilage Complex. Magn Reson Imaging Clin N Am. 2015 Aug;23(3):393-403.
  3. von Borstel D, Wang M, Small K, Nozaki T, Yoshioka H. High-Resolution MR Imaging of the Triangular Fibrocartilage Complex. Magn Reson Med Sci. 2016 Aug 16.
Lynne S. Steinbach, MD
Lynne S. Steinbach, MD
Professor of Radiology, University of California San Francisco School of Medicine | Faculty Page