High-resolution MRI of the ulnar and radial collateral ligaments of the wrist

Taiki Nozaki, Wei Der Wu, Yasuhito Kaneko, Gregory Rafijah, Lily Yang, Dave Hitt, Hiroshi Yoshioka

Research output: Contribution to journalArticlepeer-review


Background: Accurate diagnosis of injuries to the collateral ligaments of the wrist is technically challenging on MRI. Purpose: To investigate usefulness of high-resolution two-dimensional (2D) and isotropic three-dimensional (3D) magnetic resonance imaging (MRI) for identifying and classifying the morphology of the ulnar and radial collateral ligaments (UCL and RCL) of the wrist. Material and Methods: Thirty-seven participants were evaluated using 3T coronal 2D and isotropic 3D images by two radiologists independently. The UCL was classified into four types: 1a, narrow attachment to the tip of the ulnar styloid (Tip); 1b, broad attachment to the Tip; 2a, narrow attachment to the medial base of the ulnar styloid (Base); and 2b, broad attachment to the Base. The RCL was also classified into four types: 1a, separate radioscaphoid and scaphotrapezial ligaments (RS + ST) with narrow scaphoid attachment; 1b, RS + ST with broad scaphoid attachment; 2a, continuous radio-scapho-trapezial ligaments (RST) with narrow scaphoid attachment; and 2b, RST with broad scaphoid attachment. The inter-observer reliability of these classifications was calculated. Results: Type 1a was the most common of both collateral ligaments. Of UCL classifications, 31.4% were revised after additional review of multiplanar reconstruction (MPR) images from isotropic data. The inter-observer reliability of UCL classification was substantial (k = 0.62) without MPR, and almost perfect (k = 0.84) with MPR. The inter-observer reliability of RCL classification was almost perfect (k = 0.89). Anatomic delineation between the two sequences was not statistically different. Conclusion: The UCL and RCL were each identified on high-resolution 2D and isotropic 3D MRI equally well. MPR allows accurate identification of the UCL attachment to the ulnar styloid.

Original languageEnglish
Pages (from-to)1493-1499
Number of pages7
JournalActa Radiologica
Issue number12
Publication statusPublished - 2017 Dec 1
Externally publishedYes


  • high-resolution wrist MRI
  • isotropic 3D MRI
  • Magnetic resonance imaging (MRI)
  • multiplanar reconstruction
  • radial collateral ligament
  • ulnar collateral ligament

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging


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