Original CommunicationsThe effect of observer experience on magnetic resonance imaging interpretation and localization of triangular fibrocartilage complex lesions*,**
Section snippets
Materials and methods
Patients were identified retrospectively from the databases of 3 fellowship-trained hand surgeons covering the period of 1992 to 1997. Inclusion criterion was an MRI scan performed before surgical wrist arthroscopy. All patients meeting this criterion were included unless they met one of the following exclusion criteria: prior wrist surgery, inability to determine the anatomic location of a TFCC lesion based on review of the surgical report, or the presence of a fracture or avascular necrosis
Results
The study included a total of 49 patients with 51 wrists evaluated by MRI and arthroscopy. Thirty-six wrists had arthroscopically confirmed TFCC tears; 15 patients underwent arthroscopy without evidence of full-thickness TFCC perforation. There were 19 central lesions, 12 peripheral lesions, and 4 radial lesions. The data are summarized in Tables 1 and 2.Empty Cell Arthroscopic Findings MRI Evaluation No Tear Central Radial Peripheral Total No tear 15 0 0 1 16 Central 3
Discussion
Imaging of TFCC continues to evolve. Arthroscopy, however, is invasive, requires an anesthetic, and the total costs associated with the procedure are greater. At our institution the difference in cost between a diagnostic wrist arthroscopy and MRI of the wrist is approximately $2,000. As the experience with wrist MRI has evolved, investigators have examined the ability of MRI to detect lesions of the ulnar side of the wrist. Initial reports comparing MRI and arthrography found that MRI was
References (14)
- et al.
A comparison of magnetic resonance imaging and arthroscopy in the investigation of chronic wrist pain
J Hand Surg
(1997) - et al.
Magnetic resonance imaging of the triangular fibrocartilage complex
J Hand Surg
(1990) Triangular fibrocartilage disorders: injury patterns and treatment
Arthroscopy
(1990)Arthroscopic debridement of triangular fibrocartilage complex tears
Arthroscopy
(1990)- et al.
Tears of the triangular fibrocartilage of the wrist: MR imaging
Radiology
(1989) - et al.
Chronic wrist pain: evaluation with high-resolution MR imaging
Radiology
(1989) - et al.
Magnetic resonance imaging of the wrist
Magn Reson Q
(1992)
Cited by (68)
Tennis technopathies
2023, Journal de Traumatologie du SportWrist Arthroscopy Is Effective for the Diagnosis and Treatment of Chronic Wrist Pain in Pediatric Patients
2022, Arthroscopy, Sports Medicine, and RehabilitationComparison between conventional MRI and MR arthrography in the diagnosis of triangular fibrocartilage tears and correlation with arthroscopic findings
2019, InjuryCitation Excerpt :According to orthopaedic hand surgeons the gold standard for assessing lesions of the intrinsic ligaments of the wrist is arthroscopy as allows the direct visualization of the wrist joint [36–38], although recent studies claim that wrist diagnostic arthroscopy is not so reliable and should be reconsidered as a reference diagnostic tool [39]. As a method is invasive and costly, therefore diagnostic arthroscopy is reserved for patients with unequivocal or negative imaging studies with a history, symptoms and clinical examination consistent with intra articular pathology [16,17]. MRI is routinely used for assessing patients with TFCC abnormalities.
Skull fractures in post-mortem CT: VRT, flat and skin surface projections in comparison
2015, Journal of Forensic Radiology and ImagingEfficacy of Magnetic Resonance Imaging and Clinical Tests in Diagnostics of Wrist Ligament Injuries: A Systematic Review
2015, Arthroscopy - Journal of Arthroscopic and Related SurgeryCitation Excerpt :A total of 7 studies with a total of 377 patients (327 patients with MRI and 105 patients with tests) were included for final assessment in this systematic review (Fig 1). Five studies were retrospective,14-18 and 2 were prospective.19,20 Four studies were blinded, that is, the radiologist was not aware of the arthroscopic findings and diagnosis.14,16-18
MR Imaging of Wrist Ligaments
2015, Magnetic Resonance Imaging Clinics of North AmericaCitation Excerpt :Compounded by the retrospective design of many available diagnostic performance studies, the small sample sizes used, and the known error rate of the arthroscopy reference standard, the stated estimates of MR imaging accuracy, particularly specificity, should be understood to have wide confidence intervals.26,32 In addition, the expertise and experience of the interpreting radiologist is likely to affect not only accuracy but resultant clinical management.17,33,134 In contrast with the interosseous ligaments of the proximal carpal row, extrinsic ligament tears have rarely been studied.
- *
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
- **
Reprint requests: Philip E. Blazar, MD, Division of Orthopaedic Surgery, University of Kentucky, 740 South Limestone, K401 Kentucky Clinic, Lexington, KY 40536-0284.