An exact knowledge of the value of different pictorial diagnostic techniques allows a focussed and rapid diagnosis of ulnar wrist pain. A prerequisite for the choice of the best possible method of investigation is an exact clinical examination. The basic examination involves conventional recording at both the centralised at the symptomatic levels. If there is a suspicion of occult bone lesion, finely focused, magnified graphics, CT or bone scintigraphy should be used, depending on both the problem faced and availability. For tissue or ligament lesions, stress graphics, movement studies or MRT, also with contrast media, should be used. Bone scintigraphy is a suitable method to differentiate between inflammatory tissue and/or bone changes.

After complicated distal radius fractures with persistent symptoms, a variety of radiological methods may be indicated, including plain films, magnification views, examination under stress and arthrography. CT accurately differentiates abnormalities of the distal radio-ulnar joint and aids in deciding on surgical treatment. Demonstration of degenerative changes and of subluxations is much more satisfactory in the third plane, since there is no superimposition.

The absence of soft tissue superimposition on bone makes CT greatly superior to conventional radiographs, even using special views, for demonstrating the hind foot. Views derived from both methods are compared. Semicoronary and transverse planes have been defined in relation to specific points in the tarsus. In the semicoronary plane, the calcaneus-valgus angle varies from +10 degrees (valgus) to -10 degrees (varus) and the sustentaculum angle varies from 18 to 28 degrees. In the transverse plane, the plantar talocalcaneal angle is 60 degrees to 70 degrees and the calcaneal-cuboidal angle is 20 degrees to 35 degrees. These values are based on measurements of 62 normal feet. They are valuable for judging quantitatively posttraumatic deformities, displacement of fragments and operative results.

Arthrography of the wrist joint as a dynamic examination aids in confirming lesions of interosseous ligaments of the triangular fibrocartilage complex and soft tissue. The results of arthrography in 185 wrists, classified according to age of patients and pathological disorders with or without trauma demonstrate mostly post-traumatic discus lesions in younger patients. Older patients have an increase in pathological findings with a similar distribution between ligaments and discus. Soft-tissue injuries or discus lesions can be confirmed or excluded before osteoplastic surgery for distal radius fractures or reconstruction of ligaments in cases of carpal instability. Pathological changes of biomechanics of the hand and wrist are noticed more often and consequently are treated surgically. Arthrography of the wrist joint is a valuable means of diagnostic imaging.

Forty fractured calcanei (13 without and 27 with involvement of the joint) were examined by CT and the angle of the hind foot measured. Following a typical compression fracture there is a negative calcaneus-valgus angle, i.e. varus deformity of the tuberosity fragment. The sustentaculum angle is increased. There are changes in the talo-calcaneal and calcaneo-cuboidal angles. The length ratio of calcaneus to talus is reduced. Reproducible measurements make it possible to compare the results of operative correction and of changes in shape following conservative treatment, e.g. during weight-bearing.