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Magnetic Resonance Imaging of the Hand and Wrist: Techniques and Spectrum of DiseaseAAOS Exhibit Selection
Ashvin K. Dewan, MD1; A. Bobby Chhabra, MD2; A. Jay Khanna, MD, MBA1; Mark W. Anderson, MD2; Lance M. Brunton, MD3
1 c/o Elaine P. Henze, BJ, ELS, Medical Editor, Department of Orthopaedic Surgery, The Johns Hopkins University /Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue #A665, Baltimore, MD 21224. E-mail address for E.P. Henze: ehenze1@jhmi.edu
2 Departments of Orthopaedic Surgery (A.B.C.) and Radiology (M.W.A.), University of Virginia, 1827 University Avenue, Charlottesville, VA 22904
3 Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 130 Desoto Street, Pittsburgh, PA 15261
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Investigation performed at the Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland, the Departments of Orthopaedic Surgery and Radiology, University of Virginia, Charlottesville, Virginia, and the Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2013 May 15;95(10):e68 1-12. doi: 10.2106/JBJS.L.00334
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Extract

Magnetic resonance imaging (MRI) is an excellent imaging modality for the evaluation of pathologic processes of the hand and wrist. MRI of the hand and wrist provides high-resolution imaging of osseous structures and soft-tissue structures (including ligaments, tendons, nerves, and muscles) through the use of multiple imaging techniques and pulse sequences. This article updates orthopaedic surgeons on current MRI techniques and illustrates the spectrum of hand and wrist disease detectable by MRI. We searched PubMed with use of the keywords “MRI” plus “hand” or “wrist” for studies less than five years old evaluating MRI techniques. On the basis of a review of the recently published literature and the authors’ experience, we define and describe the applications of the following: (1) conventional, non-gadolinium-enhanced MRI, (2) gadolinium-enhanced MRI, and (3) MR arthrography. We also describe the classic MRI appearance of lesions commonly evaluated by MRI, including occult fracture, triangular fibrocartilage complex injury, interosseous ligament injury, extrinsic carpal ligament injury, thumb ulnar collateral ligament injury, traumatic tendon injury, finger pulley injury, ulnar impaction syndrome, tendinopathy, Kienböck disease, posttraumatic scaphoid osteonecrosis, infection, inflammatory arthropathy, compression neuropathy, and various soft-tissue masses.
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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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