A Wrist and Carpal DICOM Viewer That Runs in Your Browser

What Actually Arrives on a Wrist Study Disc

A hospital CD or portal export for the wrist rarely contains a single image — it holds a DICOMDIR index alongside folders of single-frame objects, often thousands of them for a full exam. An MRI of the wrist typically includes thin coronal, axial, and sagittal stacks with a small field of view and very fine pixel spacing, since the carpus is small and needs that level of detail; the files stay compact even with a high slice count. When contrast has been injected for an arthrogram, the study may carry separate series for the radiocarpal, midcarpal, and distal radioulnar compartments, each showing a different filling pattern. A plain radiograph exam usually arrives as four or more distinct objects — posteroanterior, lateral, oblique, and a dedicated scaphoid view taken with the wrist held in ulnar deviation. When a scaphoid fracture is suspected, the CT is often acquired obliquely along the bone's own long axis, with its own set of reformatted series layered on top of the raw acquisition.

Wrist and Carpal Conditions on DICOM

How It Works

What the Wrist DICOM Header Actually Records

Every object in a wrist study carries header fields that describe how and where it was acquired. Series Description usually names the sequence or view — coronal PD fat-sat, axial T2, scaphoid view — so stacks can be told apart without opening every file. Pixel Spacing records the physical size of a pixel in millimeters, and on a wrist MRI it is often submillimeter, reflecting how fine the acquisition has to be to resolve the TFCC or the scapholunate ligament. Image Orientation (Patient) stores the direction cosines of the imaging plane; on a scaphoid-axis CT this field shows the deliberate oblique tilt chosen to align with the bone rather than a standard coronal or sagittal plane. Slice Thickness, Study Date, and Laterality identify how thick each slice is, when the exam was performed, and which wrist was scanned — all worth confirming before comparing to an earlier study. An arthrogram carries contrast tags recording what was injected and into which compartment, and Window Center and Window Width capture the display settings the reporting radiologist used when reading bone against soft tissue, which the viewer can load as a starting point.

Telling the Arthrogram Compartments Apart

A three-compartment wrist arthrogram injects the radiocarpal joint first, then — depending on findings — the midcarpal and distal radioulnar joints, each captured as its own series. The fastest way to separate them in a folder of otherwise similar images is the Series Description field, which usually names the compartment directly. When descriptions are terse, the joint space that fills with contrast on the images themselves is the next clue: a radiocarpal series opacifies the space between the radius and the proximal carpal row, a midcarpal series fills the gap between the two carpal rows, and a DRUJ series outlines the distal radioulnar joint. Comparing series side by side lets you infer whether contrast crossed from one compartment into another — the classic sign of a TFCC or interosseous ligament tear — before a written report is even in hand. Loading the three series next to each other, rather than one at a time, is usually the fastest way to spot a crossing pattern, since a leak is easiest to see as a difference between what one compartment shows and what its neighbor does not.

MPR From an Obliquely Acquired Wrist Study

When a wrist MRI or CT series is made of contiguous slices with consistent spacing, the viewer can reconstruct coronal, axial, and sagittal planes together and render an interactive 3D volume. This matters most for a scaphoid-axis CT, where the native acquisition plane is oblique and a true coronal or sagittal view has to be built from the volume rather than read directly, and for thin MRI stacks used to trace a ligament tear across several adjacent slices at once.

Why the Disc's Bundled Viewer Rarely Matters

Most hospital wrist discs bundle a viewer application meant to run on the radiology workstation it was burned from — almost always a Windows executable, sometimes wrapped in an autorun script that never launches on macOS, Linux, or a locked-down clinical laptop. That bundled program is not the imaging data; it is a disposable reader built around it. The actual wrist study lives in the DICOM objects themselves — the DICOMDIR, the folders of coronal, axial, and sagittal slices, the radiograph objects, the arthrogram series — and those objects follow a vendor-neutral, portable format that any conformant reader can open, including one running entirely in a browser tab. Skipping the installer and opening the DICOM folder directly avoids the executable-that-will-not-run problem altogether and leaves the original files untouched on the disc or drive. It also sidesteps a second, quieter annoyance: bundled disc viewers frequently apply their own default windowing and orientation choices before you ever see the image, which can hide a subtle finding until the raw series is opened on its own terms.

AI Explanation vs a Radiology Second Opinion

AI support can translate radiology terminology and describe what a rendered wrist image shows, but it does not replace a licensed radiologist's second opinion. It is most useful for preparing focused questions before a follow-up visit — particularly when a report mentions a TFCC tear, scapholunate widening, ulnar variance, or a scaphoid fracture line that is easy to miss on a single radiograph view.

Confirm Laterality and Date Before Drawing Conclusions

Before comparing findings across a wrist study, confirm the Laterality tag matches the side that was actually scanned — left and right wrist series can end up in the same folder after a bilateral order or a prior comparison exam, and reading the wrong side's alignment or ligament signal leads nowhere useful. Check the Study Date against any earlier exam so an old healed fracture line or a prior TFCC repair is not mistaken for a new finding. On an arthrogram, verify which compartment a given series covers before drawing conclusions about contrast crossing between joints, since a radiocarpal-only injection will never show a distal radioulnar joint finding regardless of ligament status. These header checks take seconds and prevent the most common misreadings of a multi-series wrist study.

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