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Hand Soft Tissue

Wrist arthrogram and injection technique

Wrist arthrogram injection sites and technique including ulnar-sided approaches

5 questions 2 source pages

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5 questions
Q1What are the three sites of injection in a tricompartmental wrist arthrogram?▸
  • The midcarpal space
  • The distal radioulnar joint (DRUJ)
  • The radiocarpal joint (RCJ)
Q2Why are injections staged and how is sensitivity improved?▸
  • A ruptured ligament can act as a valve, so injecting at few points improves sensitivity
  • Wait ~1 hour between injections for contrast to fade away
  • Sequence RC, DRUJ, midcarpal several hours apart to eliminate the one-way valve phenomenon
  • Dynamic views open up small tears
Q3What do you look for in the radiocarpal joint injection?▸
  • Contrast pooling and abnormal communication
  • Communication with the pisotriquetral joint via the pisotriquetral orifice is normal
  • There should be no communication with the midcarpal joint
Q4What is the Swanson classification of congenital limb anomalies?▸
  • I Formation
  • II Differentiation
  • III Duplication
  • IV Overgrowth, V Undergrowth
  • VI Constriction band, VII Syndrome
Q5What is the Oberg-Manske-Tonkin classification?▸
  • Malformation/deformation: constriction ring, trigger finger
  • NOS/dysplasia: hypertrophy, tumourous
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