and Hand

Wrist, dorso-volar X-ray

  1. First metacarpal bone
  2. Capitate bone
  3. Trapezoid bone
  4. Trapezium
  5. Tubercle of trapezium
  6. Tubercle of scaphoid bone
  7. Scaphoid (navicular) bone
  8. Styloid process of radius
  9. Carpal articular surface of radius
  10. Fifth metacarpal bone
  11. Hook of hamate bone
  12. Hamate bone
  13. Triquetrum bone
  14. Pisiform bone
  15. Lunate bone
  16. Styloid process of ulna
cmp09-fig-5063
Wrist, lateral X-ray

  1. First metacarpal bone
  2. Trapezium
  3. Pisiform bone
  4. Tubercle of trapezium
  5. Scaphoid bone
  6. Styloid process of radius
  7. Carpal articular surface of radius
  8. Hook of hamate bone
  9. Trapezoid bone
  10. Capitate bone
  11. Triquetrum bone
  12. Lunate bone
  13. Styloid process of ulna
cmp09-fig-5064

Scout view of wrist and hand

Lines # 1-11 indicate position of sections (1.5 mm thick) in the following CT series. Arrows ←, →, and ↔ in the legends indicate that a structure can be seen on a previous or following section, or both.


  1. Trapezium
  2. Trapezoid bone
  3. Capitate bone
  4. Hamate bone
  5. Scaphoid bone
  6. Lunate bone
  7. Pisiform bone
  8. Triquetrum bone
  9. Styloid process of ulna
  10. Hook of hamate bone
cmp09-fig-5066cmp09-fig-5067

Wrist, axial CT



  1. Extensor pollicis longus (tendon) →
  2. Dorsal tubercle of radius
  3. Extensor carpi radialis brevis (tendon) →
  4. Extensor carpi radialis longus (tendon) →
  5. Cephalic vein →
  6. Extensor pollicis brevis (tendon) →
  7. Abductor pollicis longus (tendon) →
  8. Radial artery and veins →
  9. Median nerve →
  10. Distal edge of radius
  11. Scaphoid bone →
  12. Styloid process of radius
  13. Joint capsule with palmar radiocarpal ligament
  14. Flexor pollicis longus (tendon) ↔
  15. Flexor carpi radialis (tendon) ↔
  16. Palmaris longus (tendon) ↔
  17. Extensor indicis (tendon) →
  18. Extensor digitorum (tendons) →
  19. Extensor digiti minimi (tendon) →
  20. Extensor carpi ulnaris (tendon) →
  21. Head of ulna
  22. Distal radio-ulnar joint
  23. Ulnar nerve →
  24. Ulnar artery and veins →
  25. Basilic vein ↔
  26. Articular disc
  27. Styloid process of ulna
  28. Lunate bone →
  29. Flexor digitorum profundus (tendons) ↔
  30. Flexor carpi ulnaris (tendon) ↔
  31. Flexor digitorum superficialis (tendons) ↔
cmp09-fig-5068cmp09-fig-5069cmp09-fig-5070

Wrist, axial CT

Scout view on page 79


  1. Extensor carpi radialis brevis (tendon) ↔
  2. Extensor pollicis longus (tendon) ↔
  3. Extensor carpi radialis longus (tendon) ↔
  4. Articular capsule
  5. Extensor pollicis brevis (tendon) ↔
  6. Abductor pollicis longus (tendon) ↔
  7. Radial artery and veins ↔
  8. Abductor pollicis brevis →
  9. Cephalic vein ↔
  10. Flexor pollicis longus (tendon) ↔
  11. Flexor carpi radialis (tendon) ↔
  12. Tubercle of scaphoid bone
  13. Palmaris longus (tendon) ←
  14. Trapezoid bone →
  15. Base of first metacarpal bone
  16. Trapezium →
  17. Median nerve ↔
  18. Flexor pollicis brevis →
  19. Palmar aponeurosis →
  20. Extensor retinacle
  21. Basilic vein ↔
  22. Lunate bone ←
  23. Triquetrum bone →
  24. Capitate bone →
  25. Scaphoid bone ↔
  26. Pisiform bone →
  27. Ulnar artery and veins ↔
  28. Extensor indicis and digitorum (tendons) ↔
  29. Extensor digiti minimi (tendon) ↔
  30. Extensor carpi ulnaris (tendon) ↔
  31. Hamate bone →
  32. Flexor digitorum profundus (tendons) ↔
  33. Flexor digitorum superficialis (tendons) ↔
  34. Flexor carpi ulnaris (insertion) ←
  35. Ulnar nerve ↔
  36. Common synovial sheath of digital flexors ↔
  37. Flexor retinacle ↔
  38. Abductor digiti minimi →
  39. Flexor digiti minimi →
  40. Pisometacarpeal ligament →
  41. Pisohamate ligament
cmp09-fig-5071cmp09-fig-5072cmp09-fig-5073

Wrist, axial CT

Scout view on page 79

  1. Styloid process of third metacarpal bone
  2. Trapezoid bone ←
  3. Trapezium ←
  4. Base of first metacarpal bone ↔
  5. Tubercle of trapezium
  6. Flexor retinacle ↔
  7. Extensor carpi radialis brevis (insertion) ←
  8. Extensor carpi radialis longus (insertion) ←
  9. Extensor pollicis longus (tendon) ↔
  10. Radial artery ↔
  11. Extensor pollicis brevis (tendon) ↔
  12. Flexor carpi radialis (tendon) ←
  13. Abductor pollicis brevis ↔
  14. Flexor pollicis brevis ↔
  15. Radial artery (turning into deep palmar arch) ←
  16. First dorsal interosseus muscle →
  17. Flexor pollicis brevis, deep head
  18. Shaft of first metacarpeal bone ↔
  19. Adductor pollicis →
  20. Opponens pollicis ←
  21. Flexor pollicis longus (tendon) ↔
  22. Capitate bone ↔
  23. Hamate bone ↔
  24. Hook of hamate bone
  25. Ulnar nerve ↔
  26. Ulnar artery ↔
  27. Median nerve ↔
  28. Extensor indicis and digitorum (tendons) ↔
  29. Extensor digiti minimi (tendon) ↔
  30. Extensor carpi ulnaris (tendon) ←
  31. Abductor digiti minimi ↔
  32. Pisometacarpeal ligament ←
  33. Flexor digiti minimi ↔
  34. Palmar carpometacarpeal ligament
  35. Palmar aponeurosis ↔
  36. Base of second metacarpal bone →
  37. Base of third metacarpal bone →
  38. Base of fourth metacarpal bone
  39. Base of fifth metacarpal bone
  40. Flexor digitorum profundus (tendons) ↔
  41. Flexor digitorum superficialis (tendons) ↔
  42. Opponens digiti minimi ←
  43. Palmaris brevis
cmp09-fig-5074cmp09-fig-5075cmp09-fig-5076

Metacarpus and fingers, axial CT

Scout view on page 79


  1. Second dorsal interosseus muscle ←
  2. Shaft of second metacarpal bone ←
  3. First dorsal interosseus muscle ←
  4. Extensor pollicis longus (tendon) ↔
  5. Extensor pollicis brevis (insertion) ←
  6. Proximal phalanx of thumb
  7. Adductor pollicis ←
  8. First palmar interosseus muscle
  9. Joint capsule of third carpometacarpeal joint
  10. Fibrocartilaginous plates of palmar ligament
  11. Extensor pollicis longus (insertion) ←
  12. Distal phalanx of thumb
  13. Flexor pollicis longus (tendon) ←
  14. Tuberosity of distal phalanx
  15. Veins
  16. Head of fifth metacarpal bone
  17. Flexor digiti minimi ←
  18. Abductor digiti minimi ←
  19. Lumbrical muscles
  20. Extensor digitorum (tendon) ↔
  21. Head of third metacarpal bone
  22. Base of proximal phalanx of fourth finger
  23. Shaft of proximal phalanx of fifth finger
  24. Flexor digitorum profundus ↔
  25. Flexor digitorum superficialis ↔
  26. Shafts of proximal phalanges of second, third and fourth finger
  27. Base of middle phalanx of fifth finger
cmp09-fig-5077
Wrist, coronal MR

  1. Interossei muscles
  2. Base of fourth metacarpal bone
  3. Base of third metacarpal bone
  4. Base of second metacarpal bone
  5. Interosseous ligaments
  6. Trapezoid bone
  7. Capitate bone
  8. Scaphoid bone
  9. Styloid process of radius
  10. Base of fifth metacarpal bone
  11. Hamate bone
  12. Triquetrum bone
  13. Styloid process of ulna
  14. Articular disc
  15. Head of ulna
  16. Distal radio-ulnar joint
  17. Lunate bone
  18. Radiocarpal joint
cmp09-fig-5078
Wrist, carpal tunnel, coronal MR

  1. Lumbricals
  2. Head of first metacarpal bone
  3. Flexor pollicis brevis, and adductor pollicis
  4. Flexor pollicis longus (tendon)
  5. Base of first metacarpal bone
  6. Trapezium
  7. Proximal phalanx of fifth finger
  8. Head of fifth metacarpal bone
  9. Flexor digiti minimi
  10. Abductor digiti minimi
  11. Long flexor tendons in canalis carpi
  12. Pisiform bone
  13. Subcutaneous fat
  14. Shaft of ulna
cmp09-fig-5079
Hand, left, dorso-volar X-ray

  1. Tuberosity of distal phalanx
  2. Distal phalanx
  3. Middle phalanx
  4. Proximal phalanx
  5. Carpometacarpeal joint
  6. Hamate bone
  7. Triquetrum bone
  8. Pisiform bone
  9. Lunate bone
  10. Styloid process of ulna
  11. Head of ulna
  12. Distal interphalangeal joint “DIP”
  13. Proximal interphalangeal joint “PIP”
  14. Metacarpophalangeal joint “MCP”
  15. Distal phalanx of thumb
  16. Proximal phalanx of thumb
  17. Sesamoid bones
  18. Head of first metacarpal bone
  19. Shaft of first metacarpal bone
  20. Base of first metacarpal bone
  21. Trapezoid bone
  22. Trapezium
  23. Scaphoid bone
  24. Styloid process of radius
  25. Capitate bone
  26. Distal radio-ulnar joint
Skeletal age of hand
The skeletal development of the hand of boys and girls is displayed on the following pages 85–92
The skeletal (bone) age of each hand (left) is given according to Greulich and Pyle (1) (upper line), and according to the 20 bone scoring system of Tanner et al. (2) followed by the 10 to 90 centile interval of variation (lower line).


  1. W.W. Greulich and S.J. Pyle: Radiographic atlas of skeletal development of the hand and wrist. Stanford University Press 1959.
  2. J.M. Tanner, R.H. Whitehouse, N. Cameron, W.A. Marshall, M.J.R. Healy and H. Goldstein: Assessment of skeletal maturity and prediction of adult height (TW2 method). Academic Press 1983.
cmp09-fig-5080
Boy, newborn 0 years
cmp09-fig-5081
Boy, ½ year
cmp09-fig-5082
Boy, 1 year
cmp09-fig-5083
Boy, 1 ½ year
cmp9-math-5001 year (cmp9-math-5002)
cmp09-fig-5084
Boy, 2 years
2 years (cmp9-math-5003)
cmp09-fig-5085
Boy, 3 years
cmp9-math-5004 years (

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Dec 20, 2015 | Posted by in PEDIATRIC IMAGING | Comments Off on and Hand

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