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It extends conventional three-dimensional CT by incorporating the temporal dimension; this allows visualization of the moving wrist in just a few seconds, resulting in a fast, non-invasive and affordable method to assess and quantify kinematics. The current challenge to optimize the 4DCT workflow include improvements in scan acquisition, reconstruction, postprocessing and image analysis, and the development of advanced algorithms for accurate data processing. This article discusses important developments in this area. In addition, the use of 4DCT in the diagnosis of wrists with scapholunate instability (SLI) is presented. The observed changes in several kinematic parameters in wrists with SLI compared with the healthy wrist are reported. 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