Comparison between conventional MRI and MR arthrography in the diagnosis of triangular fibrocartilage tears and correlation with arthroscopic findings

Petsatodis, Evangelos; Pilavaki, Mayia; Kalogera, Anna; Drevelegas, Antonios; Agathangelidis, Filon; Δίτσιος, Κωνσταντίνος

doi:10.1016/j.injury.2019.07.032

Cited by 22 publications

(10 citation statements)

References 36 publications

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“…Even if MRI can confirm the presence of the ligament lesion, it fails to provide more information which is extremely important for determining surgical indication. 3.0-T MRI and magnetic resonance angiography (MRA) 33,35,36,[40][41][42][43][44][45][46][47][48] increase the detection power of the radiological investigations, but we will never get an accurate amount of information about the extent of ligament damage. This information concerning the exact location and extension of the ligament lesion, damaged tissue quality, and chondral-and osteochondral-associated lesions are all imperative information that is necessary when planning and choosing the most appropriately indicated surgical repair or reconstruction technique to the damaged ligament.…”

Section: Discussionmentioning

confidence: 99%

Comparison between MRI and Arthroscopy of the Wrist for the Assessment of Posttraumatic Lesions of Intrinsic Ligaments and the Triangular Fibrocartilage Complex

et al. 2021

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Background Magnetic resonance imaging (MRI) has been considered the most appropriate examination for wrist ligament injuries diagnosis, but it frequently fails to assess the intrinsic ligament lesion. Therefore, wrist arthroscopy is required to enhance and define the diagnosis. Purpose We compare the MRI imaging with wrist arthroscopy for intrinsic wrist ligaments (scapholunate [SL] and lunotriquetral [LT]) and triangular fibrocartilage complex (TFCC) injuries detection. Patients and Methods From 2007 to 2014, 532 patients affected by suspected SL, LT, and TFCC posttraumatic ligament injury have been investigated by 1.5-Tesla MRI and wrist arthroscopy. Inclusion and exclusion criteria were adopted. Only for SL ligament injury, the arthroscopic findings of complete (stage IV) and partial (stages I–III) SL ligament injury were compared with MRI findings. Statistical analysis, including sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and the diagnostic odds ratio, was used to compare MRI with arthroscopic findings. Results A total of 146 patients were accepted in the study. In 68 cases of arthroscopic SL ligament lesion, MRI confirmed the diagnosis only in 50% of the cases. In partial SL lesions, MRI was positive in 24.3% and in complete SL lesions, MRI was positive in 80.6% of the cases. In 10 cases of arthroscopic LT ligament lesion, MRI was positive in 30.0% of the cases. In 33 patients with arthroscopic TFCC lesion, MRI was positive in 66.7% of the cases. Conclusion 1.5-T MRI demonstrated to fail in confirming the lesion of SL, LP, and TFCC ligaments respectively in 50, 70, and 33.3% of the cases positive at arthroscopy. In complete SL ligament lesion, MRI reaches a higher sensitivity than in partial lesion. Arthroscopy remains the best method to demonstrate the ligament lesion and obtain more information regarding the extent and quality of the ligament damage. Level of Evidence This is a Level II, retrospective comparative study.

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Section: Discussionmentioning

confidence: 99%

Comparison between MRI and Arthroscopy of the Wrist for the Assessment of Posttraumatic Lesions of Intrinsic Ligaments and the Triangular Fibrocartilage Complex

et al. 2021

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“…In the literature, the reported sensitivity varies widely, between 65% and 94%. [4][5][6][7] Wide variations in practice, such as the resolution of the scanner, the thickness of the sections, and the interrater variability among radiologists, may be the reason for the variation. In 21% of our control group, a TFCC tear was found.…”

Section: Discussionmentioning

confidence: 99%

MRI Findings in Patients Undergoing Triangular Fibrocartilage Complex Repairs Versus Patients Without Ulnar-Sided Wrist Pain

Verhiel

Blackburn

Ritt

et al. 2020

Hand (New York, N,Y.)

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Background: The clinical picture of ulnar-sided wrist pain is oftentimes confusing because various pathologies may be coexistent. In this study, we aimed: (1) to compare the prevalence of potential causes of ulnar-sided wrist pain on magnetic resonance imaging (MRI) in patients who underwent triangular fibrocartilage complex (TFCC) repair and control subjects: and (2) to evaluate whether inferior clinical results were associated with specific patient characteristics or other potential causes of ulnar-sided wrist pain. Methods: We included 67 patients who underwent a TFCC repair and 67 control subjects. The MRI scans were examined for sources of ulnar-sided wrist pain. After TFCC repair, 42 patients (63%) completed surveys, including Quick Disabilities of the Arm, Shoulder and Hand and pain scores. Bivariate analysis was performed to compare our groups and to identify factors associated with our outcomes. Results: We found significantly higher rates of distal radioulnar joint (DRUJ) arthritis ( P = .033), extensor carpi ulnaris (ECU) pathology ( P = .028), and ulnar styloid fractures ( P = .028) in patients with TFCC repairs. With increasing age, increasing pathology in the pisotriquetral joint ( P = .040), more ulnocarpal abutment ( P = .0081), and more degenerative tears ( P < .001) were seen in both groups. No demographic characteristics or MRI findings were significantly associated with our outcomes. Conclusions: We observed higher rates of DRUJ arthritis and ECU pathology in patients with TFCC tears undergoing repair compared with age- and sex-matched controls. This may be due to damage to the TFCC itself altering relationships of the DRUJ and the ECU subsheath, or it may reflect various pathologies that cause ulnar-sided wrist pain and drive patients toward surgery.

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“…6 The more-common 1.5-Tesla MRI has reported sensitivity and specificity of diagnosing TFCC tears of 68% and 60%, respectively, reflecting the decrease in resolution of the images as compared with the more enhanced machines. The addition of arthrography, although invasive, can improve the diagnostic sensitivity to 95% and specificity to 100%, as Petsatodis et al 7 reported. Computed tomographic arthrogram (CTA) is also an option, but as Treiser et al 8 note, the sensitivity and specificity (0.89 and 0.89) are also lacking for the diagnosis of TFCC tears with peripheral tears, such as Palmer 1B, more difficult to identify on CTA than central tears.…”

mentioning

confidence: 91%

Editorial Commentary: Artificial Intelligence for the Wrist: Moving to the Forefront of Diagnostic Imaging for Triangular Fibrocartilage Complex Injury

Nuelle¹

2022

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Comparison between conventional MRI and MR arthrography in the diagnosis of triangular fibrocartilage tears and correlation with arthroscopic findings

Cited by 22 publications

References 36 publications

Comparison between MRI and Arthroscopy of the Wrist for the Assessment of Posttraumatic Lesions of Intrinsic Ligaments and the Triangular Fibrocartilage Complex

Comparison between MRI and Arthroscopy of the Wrist for the Assessment of Posttraumatic Lesions of Intrinsic Ligaments and the Triangular Fibrocartilage Complex

MRI Findings in Patients Undergoing Triangular Fibrocartilage Complex Repairs Versus Patients Without Ulnar-Sided Wrist Pain

Editorial Commentary: Artificial Intelligence for the Wrist: Moving to the Forefront of Diagnostic Imaging for Triangular Fibrocartilage Complex Injury

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