Overview

The carpal tunnel tangential view images the pisiform and volar aspect of the carpal bones to evaluate for pisotriquetral pathology and space occupying lesions. The beam is angled tangentially to the carpal tunnel. This projection is used selectively for specific clinical questions.

Technique

Position the wrist in hyperextension with the beam angled tangentially to the carpal tunnel. Center to the pisiform and use a small focal spot for detail. Immobilize the wrist to reduce motion and ensure reproducibility.

Clinical Indications

Carpal tunnel view is indicated for suspected pisiform fractures ganglia or space occupying lesions causing median nerve compression. It complements standard wrist series and ultrasound or MRI for soft tissue evaluation. Use selectively due to patient discomfort in hyperextension.

Image Assessment

Assess pisiform integrity volar carpal contour and presence of calcified or radiopaque lesions. Correlate with clinical signs of median nerve compression. Recommend further imaging such as MRI for soft tissue characterization.