[Radiologic skeletal diagnosis: traumatology of the distal forearm, the wrists and the hand].

Plain X-ray films including some special radiographic views are still the basis of the radiological evaluation of injuries of the distal forearm, the wrist, and the hand. Especially in the diagnosis of fractures of the distal radius the exact positioning of the arm and hand is essential. For the description of fractures of the distal forearm the AO classification of fractures should be used, which is comprehensive and universally applicable. Conventional tomography and computed tomography (CT) of the radio-ulnar joint and the wrist are used in patients with persisting complaints or equivocal findings on plain radiographs, and difficult anatomical situations. Suspected ligamentous injuries of the wrist including tears of the triangular fibrocartilage complex (TFCC) are evaluated by wrist arthrography or magnetic resonance imaging (MRI), the latter requiring a highly skilled imaging and interpretation technique. MRI is the method of choice for the detection of osteonecrosis. Ultrasound examination are of minor importance in the work up of wrist and hand injuries.