Radiology of the hand

This is an overview of radiological imaging of the hand highlighting the various imaging modalities used in the work-up and diagnosis of a range of orthopaedic and rheumatological disorders. The biomechanics and anatomy of the human hand is extremely complex, and a good understanding is required to diagnose pathology. In this article we explain the anatomy and highlight pathology of the hand from a radiological perspective with respect to plain film, CT, ultrasound and MR imaging. Trauma of the hand is extremely common and radiology plays an important role in the diagnosis of treatable injuries including fractures, dislocations and ligament tears. Plain radiography and CT are excellent at evaluating bony injury (e.g. Rolondo or Bennett's fracture) whereas ultrasound and MR are better at evaluating soft tissue injury (e.g. Stener lesion). The hands are a common location for degenerate and inflammatory arthropathies which all have hallmark radiological features. Radiology also plays an important role in the diagnosis and work-up of bone lesions in the hand including enchondromas, osteoid osteomas and chondrosarcomas.