[What does the hand surgeon expect from the radiologist in diagnostic imaging of the hand?]

backgroundFor hand surgeons, in addition to anamnesis and clinical examination, imaging is the essential component in diagnostics and the basis for therapy planning. The focus on the special field of the "hand" and the adjacent joints is limited with regard to the anatomical extent, but with regard to the possible clinical pictures it encompasses the entire range of pathological changes. CLINICAL ISSUE: Which imaging techniques support the goal of maintaining the functionality of the hand? PERFORMANCE: The carpal bones can be represented by computer tomography without superimposition. The navicular (scaphoid) should be evaluated sagittally in its longitudinal axis. MRI imaging is useful, for example, when assessing possible ligament injuries or ulnar-carpal complaints on the triangular disc. Stress images prove additional information in the case of of dynamic ligament or joint instabilities. ACHIEVEMENTS: Imaging with conventional X‑rays is the basis of radiological diagnostics of the hand. In addition, the small structures of the hand and fingers to be assessed must be specifically visualized. PRACTICAL RECOMMENDATION: In order to enable precise assessment of the fine and complex structures on the hand in relation to the clinical complaints, close communication of the anamnesis and questions with the radiologist is desirable.