About a wrist MRI scan
The wrist is a complex joint where the two forearm bones (the radius and ulna) meet eight small carpal bones, which in turn connect to the hand. These bones are held together by many small ligaments, and on the little-finger side a pad of cartilage and ligaments called the triangular fibrocartilage complex (TFCC) cushions and stabilises the joint. Tendons that move the fingers and the median nerve pass across the wrist. A wrist MRI uses a strong magnetic field and radio waves, not X-rays, to show all of these in detail.
A common reason for a wrist MRI is a suspected scaphoid fracture. The scaphoid is a small bone at the base of the thumb that is often broken in a fall onto an outstretched hand. These fractures often do not show on X-rays at first, and if missed they can heal poorly. NICE guidance recommends considering MRI as the first scan for a suspected scaphoid fracture after a careful examination.
A wrist MRI is also used to look at:
- ligament injuries, such as tears of the scapholunate ligament between two of the carpal bones
- TFCC tears, which cause pain on the little-finger side of the wrist, especially when twisting or gripping
- ganglion cysts and other lumps, including hidden ganglions that cannot be felt
- tendon problems, arthritis, inflammatory arthritis, and loss of blood supply to a bone (such as Kienböck’s disease)
- the median nerve in carpal tunnel syndrome, when the cause is unclear (this is usually diagnosed by examination and nerve tests)
For small ligament and TFCC tears, an MRI arthrogram of the wrist, where contrast is injected into the joint first, can show more detail. For the thumb or whole hand, see thumb MRI or hand MRI. You can read more in our article on wrist MRI. When you book, choose the left or right side.
What happens during the scan
Depending on the scanner, you either lie on your back with your arm by your side, or lie on your front with your arm stretched above your head (sometimes called the “superman” position). Your wrist is placed in a small coil and held still with pads. The scanner is loud, so you will wear ear plugs or headphones, and the radiographer can talk to you throughout. You need to keep your hand and wrist completely still while the pictures are taken. Contrast dye is not usually needed; where contrast is needed, it is charged separately.
What the scan can show
A wrist MRI can help to look at:
- scaphoid and other hidden fractures
- scapholunate and other ligament tears
- TFCC tears
- ganglion cysts and other lumps
- tendon problems, such as De Quervain’s tenosynovitis
- osteoarthritis and inflammatory arthritis
- Kienböck’s disease and other loss of blood supply to the bones
- carpal tunnel syndrome and nerve problems
Preparing for your scan
No special preparation is needed, and you can eat and drink normally. Remove rings, watches and bracelets before your appointment. Upload any previous X-ray or scan reports when you book, and remember to choose the correct side.
You can usually eat, drink and take your normal medicines unless the scanning centre tells you otherwise. Wear loose, comfortable clothing without metal zips or buttons, and leave jewellery at home. You will be asked to remove metal items such as hair clips, hearing aids, coins and keys, and you may be asked to change into a gown.
Before the scan you will complete a safety questionnaire. Tell the team if you have a pacemaker, any metal implant, surgical clips or other device, if you have kidney problems or allergies, or if you are, or might be, pregnant or breastfeeding. If you feel anxious in enclosed spaces, let us know when you book. Some centres can offer a relaxant, and if you take one you will need someone to take you home and must not drive for 24 hours.
Frequently asked questions
My X-ray was normal. Could I still have a fracture?
Yes. Scaphoid fractures often do not show on X-rays taken soon after an injury. An MRI can show these fractures straight away, which helps make sure you get the right treatment.
Should I have a wrist MRI or an MRI arthrogram?
A standard wrist MRI is suitable for most problems, including fractures and ganglions. An MRI arthrogram can show small ligament and TFCC tears in more detail. Your referrer will say which is needed; if you are unsure, contact us before booking.
Do I need to choose a side?
Yes. Choose the left or right wrist when you book. If both wrists need scanning, contact us so the centre can plan the appointment.
Do I need a referral?
You can tell us if you have a referral from your GP, physiotherapist, dentist or consultant and upload it when you book. If you do not have one, select “no referral” when you book and the scanning centre will confirm the next steps with you.
Sources
- NICE NG38 – Fractures (non-complex): assessment and management
- Comparison of conventional MRI and MR arthrography in the evaluation of wrist ligament tears (PMC)
- NHS – Carpal tunnel syndrome
- NHS – Ganglion cyst
- RadiologyInfo.org – Musculoskeletal MRI
- NHS – MRI scan
The information on this page has been gathered from various sources and is provided for general information only. It is not medical advice. TOP MRI is not liable for the accuracy or completeness of this information. Please speak to your doctor or the scanning centre about your own situation.