Clinical Research Directory

Added Diagnostic Value of CT Arthrography to MR Arthrography in Wrist Internal Derangement

The wrist is a complex joint made up of small bones, cartilage, and stabilizing ligaments, including the triangular fibrocartilage complex (TFCC) and intrinsic carpal ligaments. Because these structures are small and intricate, diagnosing internal joint damage (internal derangement) after trauma or chronic pain can be challenging. Magnetic resonance arthrography (MRA), an imaging scan performed after injecting a contrast dye into the joint, is widely used because it shows soft tissues clearly. However, MRA can sometimes miss subtle bone fragments, cartilage defects, or partial ligament tears due to lower spatial resolution. Computed tomography arthrography (CTA) provides higher-detail spatial imaging and excels at identifying small bone injuries and ligament tears, though it offers less soft-tissue contrast than MRI. The purpose of this study is to determine whether performing CT arthrography in addition to MR arthrography improves the detection and characterization of internal wrist pathologies compared with MR arthrography alone. Participants enrolled in this study will: * Undergo a clinical history taking and examination regarding their wrist symptoms. * Receive an ultrasound-guided injection into the radiocarpal joint using a sterile mixture containing iodinated contrast, gadolinium contrast, saline, and a local numbing medication (xylocaine). * Undergo a high-resolution CT scan of the wrist immediately following the injection. * Undergo a 1.5T MR arthrography scan. Researchers will compare the findings between the two imaging techniques to evaluate how often adding CT arthrography identifies additional lesions that were occult or inconclusive on MR arthrography.