PROTOCOLS
A Check the clinical indication and choose the correct protocol
B Read any scanning notes to ensure correct positioning and orientation
C Perform the sequences in the order indicated - this is important to ensure a diagnosis in the event the scan is abandoned
Protocols are available for
• Scaphoid fracture, AVN, SNAC or SLAC wrist
• Tendon Ligament TFCC Routine protocol
• MRA
• Synovitis screening
• Thumb injuries and Thumb pathology
• Finger injuries and Finger pathology
IMPORTANT SCANNING NOTES
• FSPD (fat saturated proton density) requires a TE of greater than 40ms **
• Slice thickness 3mm or better FOV 12-14cm unless otherwise stated
• Small surface or dedicated wrist coil
• Coronal line is between styloids (see image) sagittal perpendicular
• TILTED AXIAL for intrinsic ligaments: see images below
• Cover distal 25% forearm to mid metacarpal for wrist
• FOV = 12 Matrix 256 x 256 minimim
Scaphoid fracture, AVN, SNAC or SLAC wrist
• Axial FSPD
• Coronal FSPD
• Coronal T1
• Sag FSPD
• Axial T1 512 matrix
Tendon Ligament TFCC Routine protocol
• Axial FSPD
• Coronal FSPD
• Coronal T2*
• Sag FSPD
• Axial T1 512 matrix
Wrist MRA
• Axial FSPD and T1FS
• Coronal FSPD and T1
• Sag FSPD ..if DRUJ has not been injected
• Sag T1 ..if DRUJ has been injected
Synovitis screening
POSITION NOTE: Both hands in praying position. Patient prone hands above head.
• Coronal STIR T1
• Axial STIR (unless very dark then use FSPD)
• if above are normal
• Cor and Axial T1FS post gadolinium
Thumb injuries and Thumb pathology
POSITION AND SCAN ORIENTATION NOTE: Coronal and sagittal refer to the THUMB and are NOT the same as the fingers and wrist.
Orientate them using axial images see figure 3 opposite
Use a high resolution coil
• Axial FSPD and T1
• Coronal FSPD and T1
• Sag FSPD
Finger injuries and Finger pathology
Use a high resolution coil
• Axial FSPD and T1
• Coronal FSPD and T1
• Sag FSPD
