Evaluation of the triangular fibrocartilage complex tears by arthroscopy, arthrography, and magnetic resonance imaging

Diagnostic Accuracy of Magnetic Resonance Imaging and Magnetic Resonance Arthrography for Triangular Fibrocartilaginous Complex Injury

“…However, a lesion located in the more fibrous margin, close to the ulnar insertion, is more indicative of a symptomatic perforation requiring surgical treatment 25,51 . While some authors have suggested that radiographic arthrography and MRI investigations poorly differentiate the location of TFCC tears 13 , MRA has been suggested to possess greater diagnostic test accuracy with superior visualization of the morphology and location of the TFCC lesion 19 . Accordingly, this may be a major advantage in terms of differentiating between TFCC lesions that do and those that do not require surgical management, particularly in patients over the age of fifty years.…”

“…These include the additional cost, the invasiveness, and the need for contrast material for injection into joints 13 . As a result, as Scheck et al 19 reported, the procedure is both technically complicated and more time-consuming than conventional MRI.…”

“…The mean age of the cohorts was 34.3 years, with the means ranging from 22.4 years 2 to 43.0 years 16 ; the mean age was not documented in two papers. The time from the injury to the investigation was not documented in any paper except the one by Pederzini et al 13 , who reported a duration of eighteen months. The diagnostic test accuracy of MRI was assessed in seventeen papers and that of MRA, in eight papers.…”

“…TFCC injury has been attributed to either degenerative changes or trauma. Up to 40% of distal radial fractures have been reported to have an associated TFCC injury 9,12,13 .…”

MR arthrography is slightly more accurate than conventional MRI in detecting TFCC lesions of the wrist

“…Surprisingly, there is no study that investigated if there is a difference in diagnostic accuracy. While MRA seems slightly more accurate in our series, the use of this technique instead of MRI for patients with suspicion on TFCC injury entails some disadvantages: the need for injection of contrast material into the joint leads to a technically more complicated and more time-consuming procedure than conventional MRI with additional costs and the risk of infection [15, 22]. In addition, as described by Magee et al [13], it can result in false-positive outcomes because of so-called micro-perforations of the TFCC disc.…”