The authors retrospectively compared the diagnostic accuracy of clinical examination and magnetic resonance imaging for intra-articular wrist pathology (triangular fibrocartilage complex, lunotriquetral and scapholunate injuries), using wrist arthroscopy as the gold standard. Sixty-six patients had clinical examination and arthroscopy; 38 of them also had magnetic resonance imaging. The diagnostic accuracy of clinical examination for all three injuries combined was 56.1%, and the accuracy of MRI was 55.3%. Magnetic resonance imaging was more specific, while clinical examination was more sensitive. Clinical examination was more accurate for specific triangular fibrocartilage complex (TFCC) injuries, while magnetic resonance imaging was more accurate for lunotriquetral (LT) and scapholunate (SL) ligament injuries. The study results suggest that magnetic resonance imaging has a use where clinical examination is ambiguous or where scapholunate damage is suspected.