Indications

Standard wrist MRI has a wide range of applications, finding use in the assessment of:

• Tendons around the wrist

• Wrist and carpal joint cartilage

• Abutment syndromes (may not be optimal for suspected TFCC involvement)

Positioning

• Superman position or hand by side if not tolerated. Hand by side only works in a slim patient, as the coil must be as near to the magnetic isocentre as possible.

• Allow patient plenty of time to find comfortable position

• Encourage flexed elbow and relaxed shoulder extension rather than extreme positions

• Movement artefact is a problem due to patient discomfort in the superman position

MRI Scan

• FOV to cover from 2cm proximal to wrist joint line to bases of metacarpals
• High resolution hand and wrist coil

Sequence	TE / TR	Slice / Gap / Matrix	Other
PD SE Axial	29 / 2800	3mm / 0.4mm / 270x384	Avg2 GRAPPA 2
T2FS SE Axial	50 / 3500	3mm / 0.4mm / 270x384	Weak FS, Avg2 GRAPPA 2
PD SE Coronal	35 / 2500	3mm / 0.4mm / 512x333	Avg2 GRAPPA 2
T2 TRUFISP Coronal	5.25 / 11.78	3mm / 0.4mm / 384 x 334	Avg2
PDFS SE Sagittal	35 / 2500	3mm / 0.4mm / 192x320	Avg3

If struggling with homogeneity of fat saturation especially when scanning with hand by side, consider alternative sequences

Sequence
T2 Dixon series send in phase and water only to PACS