Dynamic wrist imaging: How it works and how to assess kinematic changes in wrists with scapholunate instability.

Thus Four-dimensional computed tomography (4DCT), dynamic imaging, is a promising innovative imaging technique that can improve the capability for diagnosis of the complex wrist joint. It extends conventional three-dimensional CT by incorporating the temporal dimension; this allows visualization of the moving wrist in just a few seconds, resulting in a fast, non-invasive and affordable method to assess and quantify kinematics. The current challenge to optimize the 4DCT workflow include improvements in scan acquisition, reconstruction, postprocessing and image analysis, and the development of advanced algorithms for accurate data processing. This article discusses important developments in this area. In addition, the use of 4DCT in the diagnosis of wrists with scapholunate instability (SLI) is presented. The observed changes in several kinematic parameters in wrists with SLI compared with the healthy wrist are reported. This knowledge will assist in the early diagnosis of SLI, the design of treatment protocols and the prediction of conditions such as radioscaphoid arthritis.