A technique adding digital subtraction to otherwise standard wrist arthrography allows more precise determination of the site of radiocarpal-midcarpal communications. Since arthrographic results often do not correlate with clinical findings, we became interested in correlating these various modalities. The precision of our arthrographic interpretation makes these correlations meaningful. In 72 consecutive patients who had digital subtraction wrist arthrograms, both clinical sites of pain and plain film abnormalities were correlated with arthrographic findings. The results indicate that those patients with ulnar-sided pain more commonly have perforations in that region (88%). Radial-sided pain is a poor indicator of a radial site of perforation. Scapholunate dissociation does not correlate highly with scapholunate perforation (26%).