Efficacy of Magnetic Resonance Imaging and Clinical Tests in Diagnostics of Wrist Ligament Injuries: A Systematic Review

Andersson, Jonny; Andernord, Daniel; Karlsson, Jón; Fridén, Jan

doi:10.1016/j.arthro.2015.04.090

Cited by 77 publications

(72 citation statements)

References 23 publications

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“…Articular cartilage of the ulna, triquetrum, and lunate were also evaluated using the Outerbridge classification on 3 T high-resolution MRI, because the presence or absence of chondromalacia is a criterion for Palmer class 2 degenerative TFCC changes. A previous study that evaluated cartilage damage associated with TFCC injury using standard 1.5 T MRI demonstrated poor diagnostic performance and poor interobserver reproducibility 7,14 ; however, in the present study, cartilage degeneration could be evaluated in detail with good interobserver reliability using high-resolution 3 T MRI and optimised wrist MRI sequences. None of the bones evaluated in the asymptomatic control subjects showed cartilage degeneration or injury, while cartilage damage was demonstrated in the patient groups.…”

Section: Discussionmentioning

confidence: 54%

High-resolution 3 T MRI of traumatic and degenerative triangular fibrocartilage complex (TFCC) abnormalities using Palmer and Outerbridge classifications

et al. 2017

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AIM: To investigate the usefulness of high-resolution 3 T magnetic resonance imaging (MRI) for the evaluation of traumatic and degenerative triangular fibrocartilage complex (TFCC) abnormalities among three groups: patients presenting with wrist pain who were (a) younger than age 50 years or (b) age 50 or older (PT<50 and PT!50, respectively), and (c) asymptomatic controls who were younger than age 50 years (AC).MATERIALS AND METHODS: High-resolution 3 T MRI was evaluated retrospectively in 96 patients, including 47 PT<50, 38 PT!50, and 11 AC. Two board-certified radiologists reviewed the MRI images independently. MRI features of TFCC injury were analysed according to the Palmer classification, and cartilage degeneration around the TFCC was evaluated using the Outerbridge classification. Differences in MRI findings among these groups were detected using chi-square test. Cohen's kappa was calculated to assess interobserver and intra-observer reliability.RESULTS: The incidence of Palmer class 1A, 1C and 1D traumatic TFCC injury was significantly (p<0.05) higher in PT!50 than in PT<50 (class 1A: 47.4% versus 27.7%, class 1C: 31.6% versus 12.8%, and class 1D: 21.1% versus 2.1%). Likewise, MRI findings of TFCC degeneration were observed more frequently in PT!50 than in PT<50 (p<0.01). Outerbridge grade 2 or higher cartilage degeneration was significantly (p<0.01) more frequently seen in PT!50 than in PT<50 (55.3% versus 17% in the lunate, 28.9% versus 4.3% in the triquetrum, 73.7% versus 12.8% in the ulna).CONCLUSION: High-resolution wrist MRI at 3 T enables detailed evaluation of TFCC traumatic injury and degenerative changes using the Palmer and Outerbridge classifications, with good or excellent interobserver and intra-observer reliability.Ó 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved. Contents lists available at ScienceDirectClinical Radiology

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Section: Discussionmentioning

confidence: 54%

High-resolution 3 T MRI of traumatic and degenerative triangular fibrocartilage complex (TFCC) abnormalities using Palmer and Outerbridge classifications

et al. 2017

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“…While advanced imaging may be helpful, diagnostic arthroscopy remains the gold standard to diagnose intercarpal ligament tears [21]. In 1996, Geissler et al proposed an arthroscopic staging system for SL injuries that has been widely applied, including to LT injuries [9].…”

Section: Diagnosismentioning

confidence: 99%

Scapholunate and perilunate injuries in the athlete

Morrell

Moyer

Quinlan

et al. 2017

Curr Rev Musculoskelet Med

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Purpose of the review Scapholunate and perilunate injuries can be difficult to diagnose and treat in the athlete. In this review article, we present the mechanism of injury, evaluation, management, and outcomes of treatment for these injuries. Recent findings Acute repair of dynamic scapholunate ligament injuries remains the gold standard, but judicious use of a wrist splint can be considered for the elite athlete who is in season. The treatment of static scapholunate ligament injury remains controversial. Newer SL reconstructive techniques that aim to restore scapholunate function without compromising wrist mobility as much as tenodesis procedures show promise in athlete patients. Summary Acute injuries to the scapholunate ligament are best treated aggressively in order to prevent the sequelae of wrist arthritis associated with long-standing ligamentous injury. Acute repair is favored. Reconstructive surgical procedures to manage chronic scapholunate injury remain inferior to acute repair. The treatment of lunotriquetral ligament injuries is not well defined.

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“…Indeed, specialized hand surgeons can request medical imaging to correctly diagnose wrist and hand disorders before surgery . The use of medical imaging to diagnose wrist and hand lesions is growing and both sonography and magnetic resonance imaging (MRI) can be used efficiently . Sonography is an easily accessible, rapid, radiation‐free, noninvasive imaging technique with useful dynamic capabilities suitable to study small and superficial structures .…”

mentioning

confidence: 99%

“…The use of medical imaging to diagnose wrist and hand lesions is growing and both sonography and magnetic resonance imaging (MRI) can be used efficiently . Sonography is an easily accessible, rapid, radiation‐free, noninvasive imaging technique with useful dynamic capabilities suitable to study small and superficial structures . Wrist magnetic resonance imaging can be challenging and expensive; therefore, it is usually performed as a second‐line imaging modality .…”

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confidence: 99%