Hand and Wrist: Normal X-ray and CT Anatomy

Abstract

The anatomy of the human hand and wrist is highly complex. Besides bones and joints, it is composed of ligaments, cartilage, tendons, nerves, vessels, and skin. In bone SPECT/CT, the focus is on bone and joint pathology. There are 29 bones in the hand and wrist, the ulna and radius included. The ulna and radius are connected with the distal radioulnar joint. The radius and ulna are connected with the proximal carpal row bones (scaphoid, lunate, triquetrum, and pisiform). The distal carpal row bones (trapezium, trapezoid, capitate, and hamate) articulate with the five midcarpal bones. Each finger has three phalanges (proximal, middle, and distal); the thumb only has two. Adding intraarticular contrast in the distal radioulnar joint, radiocarpal joint, or midcarpal joint in combination with SPECT/CT, so-called SPECT/CT arthrography, enables the indirect visualization and evaluation of important non-bony structures such as cartilage, triangular fibrocartilage complex (TFCC), and the scapholunate and lunotriquetral ligaments (Bhure et al. 2018) (Fig. 1).