Free Online Hand MRI Viewer and Reader

The axial plane cuts across the finger like rings on a tree trunk. Scrolling through it along the length of a digit is how you follow the flexor tendon from the palm to the tip, watch the A2 and A4 annular pulleys hold that tendon snug against the bone at each pulley window, and compare the radial and ulnar collateral ligaments on either side of a joint at the same slice level.

The coronal plane opens the hand out flat, side to side. It is the plane that shows the joint surfaces squarely — the metacarpal head against the proximal phalanx, or the base of the thumb metacarpal against the trapezium — and it is the plane a radiologist reaches for first when a thumb has been forced sideways, because the ulnar collateral ligament of the thumb runs across this view and a torn end curled back over the adductor aponeurosis is the classic sign of a Stener lesion.

The sagittal plane slices the finger front to back. It profiles the volar plate on the palm side of each joint and lays the extensor mechanism out along the back of the digit, from the central slip over the middle joint to the terminal tendon at the fingertip, which is why a sagittal series is usually the fastest way to spot a boutonnière or mallet pattern.

Fat-saturated, fluid-sensitive sequences suppress the bright fat signal from the marrow and subcutaneous tissue so that anything wet stands out instead: bone marrow oedema under a hairline fracture, fluid distending a tendon sheath in tenosynovitis, and the margins of a soft-tissue mass such as a ganglion or a giant cell tumor of the tendon sheath. Without fat suppression, that same fluid can hide against the naturally bright fat around it.

A finger MRI stack is short compared to most joint studies — often a few dozen sub-millimeter slices instead of a few hundred — so scrolling through the whole sequence for one digit takes seconds rather than minutes. Use the keyboard arrows or the slider to step slice by slice, then window and level to swap between a tendon-and- pulley preset and a bone preset without leaving the image.

The measurement tool turns a visual impression into a number: drag it along the expected course of a flexor tendon to size a bowstringing gap where a pulley has ruptured, or across a fluid collection to record how large a suspected ganglion or soft-tissue mass really is.

When a study includes more than one digit, or paired pre- and post-contrast series, open several of those series side by side so the same joint on two different sequences sits in view at once. When the source acquisition has enough slices at a fine enough spacing, the viewer can also reconstruct additional planes from that single series locally in your browser, which is useful for confirming a pulley or ligament finding seen on one plane against another without re-scrolling from the start.

The metacarpophalangeal, or MCP, joints sit at the knuckles where the hand meets the fingers. A report on this row usually comments on the collateral ligaments on either side of each knuckle, the volar plate underneath, and — almost always singled out separately from the other four — the thumb metacarpophalangeal joint, where an ulnar collateral ligament tear is graded by whether the torn end still lines up with the joint or has flipped past the adductor aponeurosis into a Stener lesion.

The proximal interphalangeal, or PIP, joints are the middle knuckle of each finger and the joint most often injured by a jammed or hyperextended finger. Expect comments on the volar plate, which can avulse a small bone fragment, and on the central slip of the extensor tendon just above the joint, because a missed central slip injury here is what leads to a boutonnière deformity months later.

The distal interphalangeal, or DIP, joints are the fingertip knuckles. Reports on this row focus on the terminal extensor tendon insertion, since an avulsion here — with or without a bone chip — is the mallet finger pattern, and on the flexor digitorum profundus insertion on the volar side, since a jersey finger avulses that tendon from the same joint level on the opposite surface.