Arthrography is Superior to Magnetic Resonance Imaging for Diagnosing Injuries of the Triangular Fibrocartilage

Abstract

The ability of single-injection radiocarpal arthrography and magnetic resonance imaging (MRI) to detect full-thickness tears of the triangular fibrocartilage were compared with wrist arthroscopy in 102 patients with wrist pain. The sensitivity of arthrography was 85%, and of MRI was 73%. Specificity was 100% for arthrography and 72% for MRI. Accuracy was 92% for arthrography, and 73% for MRI. Although future advances in MRI technology will probably improve its usefulness, single-injection wrist arthrography currently is superior to routine MRI for the detection of full-thickness triangular fibrocartilage tears.

Prevalence of Triangular Fibrocartilage Complex Abnormalities Regardless of Symptoms Rise With Age: Systematic Review and Pooled Analysis

“…Triangular fibrocartilage complex abnormalities were diagnosed by several modalities of which direct observation by arthroscopy or arthrotomy is considered the reference standard [1,14,21]. The cadaver studies assume donors were asymptomatic, which may be inaccurate.…”

Comparison Between High-Resolution MRI With a Microscopy Coil and Arthroscopy in Triangular Fibrocartilage Complex Injury

“…The sensitivity and specificity were 0.71 and 1.00 on the volar side and 0.75 and 0.88 on the dorsal side, respectively. Other studies, 8,9,[21][22][23] however, were not as successful. The TFCC structure was limited in that only 3 parts were evaluated:-the center disc, the radial attachment, and the proximal attachmentbecause thin slices were not taken and thus could not describe the PRUL and DRUL.…”

Wrist arthrography: a simple method

“…Arthrography is the technique of choice for the evaluation of abnormalities of the TFC and of the intrinsic ligaments of the wrist [3]. Three-compartment arthrography is used to enhance diagnostic accuracy and to identify the site of perforation [1,2], though some authors state that MR imaging, especially MR arthrography, is the most appropriate procedure for evaluation of these lesions [6][7][8].…”

“…Arthrography of the wrist, specifically three-compartment arthrography, has traditionally been recommended for the investigation of the triangular fibrocartilage (TFC) and the intrinsic ligaments of the wrist [1,[3][4][5]. Problematical aspects associated with this technique, which is usually carried out under fluoroscopic guidance, are the dose of radiation received and the length of time needed to carry out the procedure: the intraarticular insertion of the needle under fluoroscopic guidance needs a period of time that has obvious repercussions on the dose of radiation to both patient and examiner.…”