Incidental findings associated with MRI of the hand and wrist.

Beese, MA.; Gurung, P.; Hall, JA.; Shuttleworth, A.; Zhen, S.; Karia, C.; Bourke, G.; Wade, RG.

Incidental findings associated with MRI of the hand and wrist.

All Authors

Beese, MA.

Gurung, P.

Hall, JA.

Shuttleworth, A.

Zhen, S.

Karia, C.

Bourke, G.

Wade, RG.

LTHT Author

Shuttleworth, Alexander
Bourke, Grainne
Wade, Ryckie

LTHT Department

Trauma & Related Services
Plastic & Reconstructive Surgery
Hand Surgery

Publication Date

2025

Item Type

Journal Article

Abstract

OBJECTIVES: To identify the prevalence of incidentalomas and incidental findings in symptomatic patients undergoing MRI of the hand or wrist. METHODS: This retrospective cross-sectional study included all children and adults who completed MRI of the hand or wrist over a 14-year period in a single UK tertiary centre. An incidental finding was any abnormality (structural or signal-based), suspected injury or disease-process that was not already established or suspected. Incidentalomas were defined as incidental findings requiring further investigation or treatment. Marginal standardisation was used to explore relationships between prognostic factors and outcomes. RESULTS: Overall, 490 out of 2138 (22.9%) scans contained 1 or more incidental anomalies and 67 (3.1%) had at least 1 incidentaloma. The risk of incidentalomas doubled (risk ratio (RR), 1.93; 95% CI, 1.01 to 3.70) when reported by a trainee and reviewed by a consultant compared to a consultant alone; increased by 12% (RR, 1.12; 95% CI, 0.98 to 1.28) per additional decade of life; and were less likely (RR, 0.34; 95% CI, 0.12 to 0.94) when contrast was used. Three incidentalomas were found to be malignant (3.3%). CONCLUSIONS: The risk of incidentalomas and incidental findings in MRI of the hand and wrist is lower than solid organs. Our data may be used to inform patients about the risks of imaging and allow health services to plan the capacity and capability to deal with such events. ADVANCES IN KNOWLEDGE: One in 4 hand or wrist MRIs yields an incidental finding and out of these, around 1 in 7 required further action.