Radiography and Arthrography
The main emphasis of this chapter is a description of basic radiography of the wrist and hand with detailed description of radiographic technique and evaluation of the different projections. Static and dynamic carpal instability evaluation is vital for the assessment of ligamentous disruption. These techniques are covered in this chapter. There are a whole variety of measurement techniques which can be used in the assessment of wrist pathology. Following distal radial fracture, radial inclination, radial length and palmar tilt are important. Ulna variance is also assessed following distal radial fracture and in the context of ulnar-sided wrist pain. The scapholunate angle and capitate lunate angle are assessed when intercalated instability is suspected. Finally, the carpal height is a measurement which is applied when there is evidence of carpal collapse or loss of joint space. Arthrography still has a place in the modern assessment of the wrist. Radiocarpal and to a lesser extent midcarpal injection techniques may be employed.