Extrinsic and intrinsic ligaments of the wrist: normal and pathologic anatomy at MR arthrography with three-compartment enhancement

The ligaments of the wrist have been demonstrated with magnetic resonance (MR) imaging by many authors. Distinction has been made between the extrinsic, or radiocarpal and ulnocarpal, ligaments and the intrinsic, or intercarpal, ligaments. The stability of the wrist depends on numerous ligaments: The volar ligaments are important stabilizers of the wrist, whereas the dorsal ligaments are less crucial for wrist stability. An MR imaging protocol that demonstrates these structures with high resolution has been developed. Cadaveric wrists are imaged with a spoiled gradient-recalled-echo volume-acquisition technique with fat suppression after three-compartment enhancement with a contrast agent containing gadolinium. The specimens are then sectioned, and the anatomic and pathologic findings are correlated with the findings on the MR images. The extrinsic and intrinsic ligaments of the wrist are clearly demonstrated with this technique. This protocol was designed for anatomic study and promotes understanding of the anatomy and biomechanics of the wrist; it is not intended for clinical use.