CT arthro-scan of the traumatic wrist

A CT arthrography is almost always needed in the diagnostic evaluation of any wrist trauma, whether involving ligament, cartilage or bone injury. To correctly analyze a CT arthrography, it must be performed under adequate conditions and include an injection in every three main compartments, adapted slices to analyze both the inter osseous and capsular ligaments which are in different planes. A thorough knowledge of wrist anatomy and physiology is necessary to better interpret the images. A ligament tear is not synonymous to instability; Dye leakage between midcarpal and the radio-carpal compartments can be observed in a different location than the inter osseous spaces. Pain localization is not helpful to interpret the images. CT arthrography cannot be used in place of a correct physical examination, but only the CT arthrography provides the exact anatomical diagnosis of lesions. CT arthrography is an invaluable tool for proper choice of treatment. (authors)