Which Wrist MRI, X-ray, and Arthrogram Files This Viewer Opens

What a wrist imaging order usually contains

Wrist MRI is almost always acquired on a dedicated small extremity coil, with the arm either overhead or resting at the side depending on the scanner and the referring question. The core of the study is a set of thin coronal proton-density and gradient-echo series angled across the triangular fibrocartilage complex and the scapholunate ligament, since those two structures drive most of the clinically relevant findings, plus an axial series through the carpal tunnel when nerve compression is a concern.

When plain MRI leaves a ligament tear ambiguous, a radiologist injects contrast into one, two, or all three wrist compartments — radiocarpal, midcarpal, and distal radioulnar — and re-scans, producing an MR arthrogram made up of several distinct series rather than a single sequence.

Radiographs cover more ground than a single view: a standard wrist series includes PA, lateral, and oblique projections, and a fall onto an outstretched hand typically adds dedicated scaphoid views along with grip and ulnar-deviation stress views to unmask a subtle fracture line. When a scaphoid fracture needs to be followed for healing, CT is reformatted along the scaphoid's own axis rather than the body's anatomical planes, since that is the only angle that shows the fracture line cleanly along its full length.

How wrist imaging is usually packaged when it reaches you

Because the wrist has a small field of view and very fine pixel spacing, MRI and X-ray exports both tend to be compact compared to studies of larger joints — a whole visit can fit in a fraction of the space a knee or hip study needs. A three-compartment arthrogram is the exception: expect it as several series bundled into one folder rather than a single sequence, since each injected compartment is scanned and saved separately.

An emergency department scaphoid series after a fall often reaches you through a patient portal as a handful of loose DICOM files with no folder structure at all — those drop straight into the viewer without any preparation. Hospital-issued CDs are the more common route for the MRI side, usually holding a DICOMDIR index next to the actual DICOM folder; drag that folder in as-is rather than hunting for individual files inside it.

ZIP archives are common when a clinic exports an entire wrist visit at once, and NIfTI files show up occasionally from research pipelines studying carpal instability or cartilage mapping — both formats load the same way as native DICOM once dropped in.

Archive formats

If your scan came as one big compressed file, drop it directly into the viewer — we unpack it in your browser.

• ZIP — the most common format on hospital CDs and patient-portal downloads
• TAR — common for research datasets
• .tar.gz and .tgz — TAR + GZIP compressed

DICOM transfer syntaxes

The technical format used to encode pixel data inside a DICOM file. Our viewer decodes every common transfer syntax used by clinical scanners.

• Implicit VR Little Endian (1.2.840.10008.1.2)
• Explicit VR Little Endian (1.2.840.10008.1.2.1)
• JPEG Lossless (1.2.840.10008.1.2.4.70)
• JPEG Extended 12-bit (used by i-CAT dental CBCT)
• RLE Lossless
• 8-bit, 12-bit, and 16-bit pixel data
• MONOCHROME1 and MONOCHROME2 photometric interpretations

NIfTI (research / converted scans)

NIfTI (Neuroimaging Informatics Technology Initiative) is the format used by most research and post-processing tools. If you ran your scan through a pipeline like FreeSurfer or fastMRI, you likely have a NIfTI file.

• .nii — uncompressed NIfTI volume
• .nii.gz — GZIP-compressed NIfTI (most common)

What slice thickness means for a wrist 3D reconstruction

A coronal or axial wrist MRI series is typically captured with sub-millimetre in-plane resolution but only 2 mm between slices, which delivers excellent detail through the triangular fibrocartilage complex and the scapholunate ligament on the native plane while leaving a stack that is simply too thin, front to back, to volume render smoothly — you will see step artifacts if you try to spin it into a 3D model.

Scaphoid-axis CT behaves differently: it is acquired at an oblique angle chosen to follow the bone's own long axis rather than a standard body plane, so reformatting it lines up naturally along the fracture rather than requiring a fresh angle to be found after loading. That obliquity is intentional, not a defect in the file.

A single scaphoid-view radiograph, meanwhile, stays exactly what it is — a flat two-dimensional projection with no slice data behind it — no matter how many other views or MRI series ride along in the same upload.

Compatibility at a glance

Privacy and 3D viewing guides

When a wrist study won't open the way you expect

A three-compartment arthrogram exported as several separate ZIPs, one per compartment, will still open fine — just drop each ZIP in one at a time and let the viewer merge them into the same session rather than trying to combine the archives yourself first. A post-operative wrist carrying screws or a plate loads normally too; the hardware only affects how the pixels look near the metal, not whether the underlying files parse. The genuine dead ends are password-protected hospital CDs, which no browser-based viewer can open without an unprotected re-export, and vendor measurement reports saved as PDFs or screenshots instead of DICOM — those were never imaging files to begin with.