Magnetic resonance imaging (MRI) is a modern high-precision method for diagnosing various diseases of internal organs and joints. Of particular value is the MRI of the hand, since this is almost the only way to accurately determine the pathology that develops in the soft tissues of the hand.
The principle of MRI
MRI is based on the principle of nuclear magnetic resonance. Its essence lies in the fact that the electromagnetic field that is present in the tomograph is capable of capturing the energy emanating from the nuclei of atoms. The computer, in turn, displays this energy and captures it in the form of an image.
The highest concentration in the human body are hydrogen nuclei. It is on capturing the difference in their concentrations and the energy emitted by them that the image of internal organs and tissues on a computer is based.
A feature of MRI is that bone tissue is not displayed on the image, which allows you to carefully consider the structure of soft tissues. Therefore, MRI of the joints of the hands has become so widespread. You can clearly see damage to any component of the joint, and the bones will not interfere with this.
When is it necessary to do an MRI?
X-ray examination is considered a traditional method for diagnosing hand pathology. However, this diagnostic method allows you to see only a violation of the structure of bone tissue, while joints and cartilage are ignored. When is it worth doing an MRI of the hand?
- Prolonged pain in the joints of the hand.
- Damage to the muscles of the hand.
- Impairment of movement in the wrist joint.
- Pinched nerves of the hand.
- For the diagnosis of arthritis, gout, osteomyelitis.
- Suspicion of the presence of purulent inflammatory process of soft tissues of the hand - phlegmon.
- The presence of neoplasms on the hand.
- Clinical signs of tunnel syndrome.
- Lack of effectiveness of treatment measures that were carried out earlier.
- When planning a surgical intervention and after it is carried out - to evaluate the effectiveness of the operation.
What can be seen with MRI?
By its diagnostic value, MRI of the wrist joint and hand is inferior only to arthroscopy. The latter is a surgical procedure in which the surgeon, using a special device, inserts the camera into the joint cavity and examines its structure. But this diagnostic method requires damage to the integrity of the skin, so you must first do an MRI.
What does an MRI of the hand show?
- Hand and arm injuries.
- Inflammation of the tendons and tissues surrounding the joint is tenosynovitis.
- Rupture of the tendons of the hand.
- Inflammatory processes in the joints: of an infectious nature and an autoimmune nature (with rheumatoid arthritis, systemic lupus erythematosus).
- Deposition of uric acid crystals in joints with gout.
- Softening of tissues with osteoporosis.
- The presence of tumors in the tissues of the hand.
- Congenital malformations of the joints.
- Violation of blood flow in the tissues of the hand.
When is contrast needed?
MRI of the hand with contrast is a more informative method compared to classical MRI diagnostics. In this case, the drug "Gadolinium" is used, which is absolutely safe for the body. Before the introduction of this substance, it is necessary to conduct a skin test to exclude the presence of allergies in the patient.
Contrast is necessary for fast staining of blood vessels. It is mainly used for suspected neoplastic process, as blood supply is increased in the area of the neoplasm, therefore, the contrast medium accumulates actively. It accurately shows the extent of tissue damage. This is especially valuable when planning surgical intervention and monitoring its effectiveness.
MRI preparation
To obtain more accurate results when conducting magnetic resonance imaging, it is necessary to adhere to a number of rules.
For example, you need to wear the right clothes. It should not contain any metal accessories: buttons, plaques, fasteners. It is also necessary to remove all jewelry.
If a person is extremely excited and worried about a future examination, the doctor may prescribe him sedative medications (valerian infusion) or more powerful tranquilizers.
Must remember! The use of sedative drugs is possible only after the permission of the doctor.
MRI preparation with contrast
If MRI is performed with contrast, that is, the introduction of contrast intravenously, a diet must be observed before the examination. The patient should refuse to eat at least 10 hours before an MRI of the joints of the hands, since the contrast can cause nausea and vomiting.
If the patient is allergic to the contrast medium, he must warn the doctor about this. In cases where the patient does not know if he has an allergy, an allergic test is performed before the examination. To do this, the doctor introduces the patient a small amount of contrast subcutaneously, and then monitors the reaction of the skin. If there are any signs of allergies (redness, itching, rash), you must refuse to introduce contrast or replace it with another substance.
Also, contrasting is contraindicated in diseases of the kidneys and urinary tract, since in these conditions it is difficult to remove the coloring matter from the body. If the patient has any violation of the urinary system, he must warn the doctor about this.
How is an MRI of the hand done?
In order to see in detail all the soft tissues of the brush, a special apparatus is used - a tomograph. The patient is placed on the table of the tomograph. His head, arms and legs are firmly fixed to the table. This is a necessary step in order to exclude the slightest movements, since they degrade the image quality.
Next, the table slides into the tomograph, the patient’s hand is scanned, and the image is displayed on the operator’s computer. A tomograph ring rotates next to the hand, making a barely audible crack. As a rule, the whole process takes no more than half an hour.
Magnetic resonance imaging with the introduction of contrast is carried out a little longer. After an allergy test, contrast is injected through a catheter into the peripheral vein. "Gadolinium" stains the vascular system of the whole body, which allows you to see tumor-like formations of the hand, to accurately assess the extent of damage. In the presence of oncology, the blood supply to the corresponding area of the hand will be increased.
The introduction of contrast when performing MRI increases the cost and duration of the examination by 2 times, but also increases the information content of the diagnosis.
After an MRI, the radiologist needs some time to decipher the results. At the end, the patient receives images and a detailed description of the diagnostician.
Important! The radiologist cannot make a final diagnosis, he only describes what he saw.
The clinical diagnosis should be made by the attending physician based on the patient's complaints, medical history and, in fact, the results of MRI.
The patient immediately after examination can return to his usual affairs, there are no restrictions on further activities.
Contraindications to MRI
An MRI of the hand is not allowed in the following cases:
- pregnancy;
- age up to 7 years;
- the presence in the body of metal objects: pacemakers, prostheses of joints and limbs, an insulin pump, prosthetics of heart valves, dental crowns, clips on blood vessels. Moreover, the presence of titanium plates and dental crowns made of plastic is not a contraindication;
- the presence of mental illness;
- with hyperkinesis - a condition in which involuntary movements of various parts of the body occur;
- with claustrophobia - fear of confined space, the exception is open-type tomographs;
- the inability to transport to an MRI room.
Severe renal or heart failure is a contraindication to the introduction of contrast.
Children under 7 years are allowed to conduct magnetic resonance imaging exclusively in the presence of strict indications, when the intended benefit exceeds the possible harm.
Benefits of MRI
One of the undoubted advantages of diagnosing hand pathology with MRI is its high accuracy. Also, an MRI of the hand in joint disease has several other advantages:
- complete absence of radiation exposure;
- the possibility of obtaining images of tissues covered with bones;
- better display of pathology due to image acquisition in different planes;
- this is the only diagnostic method that is informative in case of damage to the nerve tissue: with its help you can accurately see the location, type and level of nerve damage;
- informative when planning a surgical intervention, as it accurately shows all the structures of the hand;
- the contrast from Gadolinium is safe and rarely causes allergic reactions;
- immediately after the diagnosis, the patient can return to his business: there is no need for further monitoring in a hospital.
Disadvantages of MRI
In addition to the undoubted advantages, MRI of the hand, like any other diagnostic method, has a number of disadvantages:
- it is impossible to perform for people with foreign metal bodies;
- in the presence of hemorrhages in the tissue of the hand, a computer tomogram is more informative;
- the need for a fixed position for half an hour also limits its use in a particular group of people.
Risks to the patient are extremely low, but they do occur.
Firstly, there is always the possibility of an anaphylactic reaction to a contrast medium.
Secondly, if the doctor ignores the patient’s presence of metal objects or forgets to ask if he has them, it is possible not only a distortion of the final results, but also a breakdown of the device.
Nursing mothers need to stop breastfeeding for several days after MRI with contrast, since it can pass into the body of the baby with breast milk.
Where to do an MRI of the hand?
There are many private diagnostic centers where you can do MRI. MRI prices in Moscow range from 4,000 p. up to 8 000 r. Below is a list of such centers:
- "MRT Tushino" - Voloklamskoe highway, 95;
- "European Diagnostic Center" - st. Nagatinskaya, d.1;
- "Kuntsevo treatment and rehabilitation center" - st. Partizanskaya, d. 41;
- “MRT-Center” - Kurkinsoke highway, 30;
- "REMSI Diagnostics" - st. Malaya Pirogovskaya, d.13; st. Krasnoproletarskaya, d.16;
- "MRI 24" - st. Ordzhonikidze, d.11; st. Kalanchevskaya, d.17.
Thus, MRI of the hand is an informative and highly accurate examination, which makes it possible to find out almost any reason for the violation of the structure and function of the upper limb.