What position are you in for a hand MRI?
Arm MRI scan
An arm MRI (magnetic resonance imaging) scan uses strong magnets to create pictures of the upper and lower arm. This may include the elbow, wrist, hands, fingers, and the surrounding muscles and other tissues.
It does not use radiation (x-rays).
Single MRI images are called slices. The images can be stored on a computer or printed on film. One exam produces many images.
How the Test is Performed
You will wear a hospital gown or clothes without metal zippers or snaps (such as sweatpants and a t-shirt). Make sure you take off your watch, jewelry, and wallet. Some types of metal can cause blurry images.
You will lie on a narrow table that slides into a large tunnel-like scanner.
Some exams use a special dye (contrast). Most of the time, you will get the dye through a vein in your arm or hand before the test. The dye helps the radiologist see certain areas more clearly.
During the MRI, the person who operates the machine will watch you from another room. The test most often lasts 30 to 60 minutes, but may take longer.
How to Prepare for the Test
You may be asked not to eat or drink anything for 4 to 6 hours before the scan.
Tell your health care provider if you are afraid of closed spaces (have claustrophobia). You may be given a medicine to help you feel sleepy and less anxious. Your provider may suggest an «open» MRI, in which the machine is not as close to the body.
Before the test, tell your provider if you have:
- Brain aneurysm clips
- Certain types of artificial heart valves
- Heart defibrillator or pacemaker
- Inner ear (cochlear) implants
- Kidney disease or dialysis (you may not be able to receive contrast)
- Recently placed artificial joints or surgery with metal plates and screws
- Certain types of vascular stents
- Worked with sheet metal in the past (you may need tests to check for metal pieces in your eyes)
Because the MRI contains strong magnets, metal objects are not allowed into the room with the MRI scanner:
- Pens, pocketknives, and eyeglasses may fly across the room.
- Items such as jewelry, watches, credit cards, and hearing aids can be damaged.
- Pins, hairpins, metal zippers, and similar metallic items can distort the images.
- Removable dental work should be taken out just before the scan.
How the Test will Feel
An MRI exam causes no pain. You will need to lie still. Too much movement can blur MRI images and cause errors.
The table may be hard or cold, but you can ask for a blanket or pillow. The machine makes loud thumping and humming noises when turned on. You can wear ear plugs to help block out the noise.
An intercom in the room allows you to speak to someone at any time. Some MRIs have televisions and special headphones to help the time pass.
There is no recovery time, unless you were given a medicine to relax. After an MRI scan, you can return to your normal diet, activity, and medicines.
Why the Test is Performed
This test provides clear pictures of parts of the arm that are hard to see clearly on CT scans.
Your provider may order this test if you have:
- A mass that can be felt on a physical exam
- An abnormal finding on an x-ray or bone scan
- Arm pain and a history of cancer
- Arm or wrist pain that does not get better with treatment
- Bone infection (osteomyelitis)
- Bone pain and fever
- Broken bone
- Decreased motion or «locking up» of the wrist or elbow joint
- Redness or swelling of the wrist or elbow joints
- Injuries to the cartilage and ligaments
- Deformity to allow your physician assess the condition better
A normal result means your arm looks OK.
What Abnormal Results Mean
Abnormal results may be due to:
- Degenerative changes due to age
- Bursitis of the elbow or wrist
- Broken bone or fracture
- Ganglion cyst in the wrist
- Infection in the bone
- Ligament, tendon, or cartilage injury in the wrist or elbow
- Muscle damage
- Osteonecrosis (avascular necrosis)
- Tumor or cancer in the bone, muscle, or soft tissue
Talk to your provider if you have questions and concerns.
MRI contains no radiation. There have been no reported side effects from the magnetic fields and radio waves.
It is also safe to have MRI performed during pregnancy. No side effects or complications have been proven.
The most common type of contrast (dye) used is gadolinium. It is very safe. Allergic reactions to the substance are rare. However, gadolinium can be harmful to people with kidney problems that need dialysis. If you have kidney problems, please tell your provider before the test.
The strong magnetic fields created during an MRI can cause heart pacemakers and other implants to not work as well. It can also cause a piece of metal inside your body to move or shift. For safety reasons, please do not bring anything that contains metal into the scanner room.
Tests that may be done instead of an MRI of the arm include:
A CT scan may be preferred in an emergency. The test is faster than MRI and often available in the emergency room.
MRI — arm; Wrist MRI; MRI — wrist; Elbow MRI; MRI — elbow
Anderson MW, Fox MG. MRI of the arm. In: Anderson MW, Fox MG, eds. Sectional Anatomy by MRI and CT. 4th ed. Philadelphia, PA: Elsevier; 2017:chap 4.
Kapoor G, Toms AP. Current status of imaging of the musculoskeletal system. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. Grainger & Allison’s Diagnostic Radiology. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 38.
Review Date 6/13/2021
Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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We will make sure you are as comfortable as possible for your exam. In most situations, we may provide you with a leg cushion that provides back support, a warm blanket, and even prism glasses that will allow you to see the room outside the bore of the magnet (toward your feet). The scanner also has proper ventilation and lighting that may help you feel more comfortable.
MRI does not use ionizing radiation
Unlike X-rays, which use ionizing radiation, MRI uses non-ionizing approach to image the anatomy of the body. The type of non-ionizing energy is called radio-frequency (RF) waves. Unlike X-rays, RF waves do not break strands of DNA. This is one reason why MRI is a safer alternative as opposed to X-rays, and is a modality of choice for pregnant and pediatric patients
You are always in control
MRI technologist will give you a “call ball” to hold for the duration of your exam. The “call ball” will allow you to have constant communication with the MRI technologist. If the ball is squeezed, it will alert the technologist that you want to stop the exam for a moment and come out of the scanner. This will allow you to discuss some concerns you have with your technologist; such as deciding whether or not you want to complete the exam.
If you are having second thoughts about the exam, the technologist will discuss with you some of your alternative options.
We are always here for you
The technologist will always maintain visual contact with you. Even though the door between the MRI scanner and MRI technologist workstation must be closed. Each MRI room has a large glass window that allows the MRI technologist to always maintain visual contact.
Please Ask Questions. Be sure to ask your MRI technologist the questions you might have about your exam. Informing yourself of your MRI exam will hopefully offer more ease of mind since you will be aware of the entire procedure.
How to relax and combat claustrophobia
If you are suffering from claustrophobia, tell your Doctor before scheduling your MRI appointment.
Claustrophobia is a condition of persistent, and excessive fear of enclosed or small spaces. In such people, exposure to an enclosed or small space such as that found in MR systems, Often provokes an immediate anxiety response that, in its most extreme form, is indistinguishable from the panic attack described above.
Some researchers claim that as many as 20% of the people attempting to undergo MR procedures can’t complete the exams due to serious distress such as claustrophobia.
One way to combat with your claustrophobia is by doing mind exercises.
Try to determine what triggers your anxiety and attempt to block that out of your mind. Use self-talk to talk yourself out of the situation, e.g., “I’m going to get through this, this feeling will pass shortly”.
Think about what is on the outside. The MRI technologist always keeps an eye on you so that you are not by yourself. The technologist is on the other side of the window setting up your exam. Even though it may seem as though your are in a confined space, your MRI takes place in a large room.
Another way to help with your claustrophobia is by using breathing techniques. Although you may believe that taking deep breaths will help, this will actually make it even worse. Instead, take slow breaths.
Having a support system may also help you get through your exam. In most cases, a family member or friend may enter the MRI room with you and stay with you throughout your exam. If the situation allows, they may even hold your hand or pat you on the knees so that you know that they are there with you.
If none of these help you get through your exam, you may speak to your doctor so that they can provide you with medication. Often times, the medication will help you calm down enough to get through the exam. It is important, however, to be accompanied by someone so that they can drive you home since the medication may cause dizziness.
If you attempted to have your MRI with medication and you are still unable to complete the exam, the final option would be to undergo the exam with general anesthesia.
• Mind Exercise
• Breathing Exercise
• Family Support
• General Anesthesia (as a last resort)