High-resolution MRI (3T-MRI) in diagnosis of wrist pain: is diagnostic arthroscopy still necessary?

Ochman, Sabine; Wieskötter, Britta; Langer, Martin; Vieth, Volker; Raschke, MJ; Stehling, Christoph

doi:10.1007/s00402-017-2747-2

Cited by 42 publications

(17 citation statements)

References 51 publications

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“…High-resolution 3 T MRIs availability is increasing and shows more detailed image quality. Despite showing promising results for ligamentous injuries in the wrist, the specificity concerning TFCC lesions is still unsatisfactory [33].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of radiological instability signs in the distal radioulnar joint in children and adolescents with arthroscopically-verified TFCC tears

Schachinger

Wiener²,

Carvalho³

et al. 2020

Arch Orthop Trauma Surg

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Introduction Recent reports in the adult literature reported the use of standardized radiographic measurement techniques to determine distal radioulnar joint (DRUJ) instability. The aim of this study was to evaluate the efficacy and accuracy of (1) the MRI-based modified radioulnar ratio technique and (2) the pisoscaphoid (PiSca) and radioulnar (RaUl) distances in true lateral radiographs in children and adolescents with arthroscopically-verified TFCC tears. Materials and methods We retrospectively assessed lateral wrist radiographs and axial MRI sequences of 18 adolescent patients (22 wrists) who had arthroscopically-confirmed TFCC tears and compared them to similar imaging of a control group of 28 healthy patients (28 wrists). Three raters assessed the images twice in a 2-week interval. Intraclass correlation coefficients (ICCs), unifactorial ANOVA, and ROC analysis were performed with regards to the different radiographic variables. Results The interrater ICCs were almost perfect for all measurements except RaUl1, which showed a substantial agreement (0.751) among the three observers. The intrarater ICCs were almost perfect when measuring PiSca and MRI, and substantial to almost perfect for RaUl. Pearson's correlation showed a moderate, positive correlation between PiSca and RaUl distances (r = 0.608; p < 0.001), and a moderate, negative correlation between RaUl distance and MRI shift (r = − 0.486; p = 0.010). When the three core groups (peripheral, central tear, controls) were compared to each other regarding the radiographic instability parameters, only the MRI shift revealed a statistically significant difference (p = 0.003). Comparisons revealed significant differences between patients and controls (p = 0.004) and peripheral tears vs. controls (p = 0.001 and p = 0.010). The ROC analysis revealed a significant AUC only for the MRI (AuC 0.787 and p = 0.002). Conclusions Children and adolescents with peripheral TFCC tears showed significantly increased instability parameters in MRI compared to controls. These measurement techniques are no replacement for a thorough clinical examination but may be helpful for indicating diagnostic wrist arthroscopy in ambiguous cases. Level of evidence Level III; Diagnostic.

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Section: Discussionmentioning

confidence: 99%

Evaluation of radiological instability signs in the distal radioulnar joint in children and adolescents with arthroscopically-verified TFCC tears

Schachinger

Wiener²,

Carvalho³

et al. 2020

Arch Orthop Trauma Surg

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“…In these cases, the reported diagnostic accuracy of MRI can be useful in deciding on treatment options. 16 Finally, for similar reasons, MRI for biceps/triceps injuries resulted in a treatment change in 33% of patients (5/15).…”

Section: Discussionmentioning

confidence: 98%

MRI Utility in Hand Surgery

DeFrance

Lutsky

Ilyas

et al. 2019

Hand (New York, N,Y.)

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Background: Magnetic resonance imaging (MRI) is frequently used in the diagnosis of upper extremity conditions. We hypothesize that the results often do not change treatment. The purpose of the present study was to prospectively assess the extent to which MRI findings alter patient management. Methods: Ten hand surgeons who were ordering an MRI (elbow or distal) completed a standardized questionnaire. Prior to obtaining the MRI, the surgeon recorded their pre-MRI diagnosis and recommended treatment if no MRI could be obtained. Following the MRI, the surgeon recorded their post-MRI diagnosis and ultimate treatment recommendation. Finally, the surgeon answered whether the MRI was helpful, and if so, how it helped guide their treatment. Descriptive statistics were performed. Results: One hundred eighty-seven MRIs were ordered. The most common reasons for ordering an MRI were the evaluation of presumed occult scaphoid fracture, ulnar wrist pain, metacarpophalangeal joint collateral ligament injury, and mass. The surgeon agreed with the radiologist’s interpretation of the MRI in 88% of cases. Overall, surgeons found the MRI to be helpful in 92% of cases, and the recommended treatment changed as a result of the MRI findings in 19% (35/187) of patients. Of these 35 patients, 9 had a pre-MRI diagnosis that was concordant with the MRI findings, but the proposed management of the patient changed after the MRI. Conclusions: Hand surgeons infrequently change their treatment plan based on MRI findings. Given the importance of cost-efficient care, indications for use of MRI may need to be re-evaluated.

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“…Arthroscopy consists of a thin tube (arthroscope) carrying a flashlight and a camera to peek through the joint. It is used to diagnose any joint debilitating and/or arthritic alterations, to classify bone disorders and tumors, and to evidence the severity of bone inflammation and pain [95,96].…”

Section: Nanomaterials For the Diagnosis Of Inflammatory Arthritis 2mentioning

confidence: 99%

Nanomaterials for the Diagnosis and Treatment of Inflammatory Arthritis

Hosseinikhah

Barani

Rahdar

et al. 2021

IJMS

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Nanomaterials have received increasing attention due to their unique chemical and physical properties for the treatment of rheumatoid arthritis (RA), the most common complex multifactorial joint-associated autoimmune inflammatory disorder. RA is characterized by an inflammation of the synovium with increased production of proinflammatory cytokines (IL-1, IL-6, IL-8, and IL-10) and by the destruction of the articular cartilage and bone, and it is associated with the development of cardiovascular disorders such as heart attack and stroke. While a number of imaging tools allow for the monitoring and diagnosis of inflammatory arthritis, and despite ongoing work to enhance their sensitivity and precision, the proper assessment of RA remains difficult particularly in the early stages of the disease. Our goal here is to describe the benefits of applying various nanomaterials as next-generation RA imaging and detection tools using contrast agents and nanosensors and as improved drug delivery systems for the effective treatment of the disease.

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High-resolution MRI (3T-MRI) in diagnosis of wrist pain: is diagnostic arthroscopy still necessary?

Cited by 42 publications

References 51 publications

Evaluation of radiological instability signs in the distal radioulnar joint in children and adolescents with arthroscopically-verified TFCC tears

Evaluation of radiological instability signs in the distal radioulnar joint in children and adolescents with arthroscopically-verified TFCC tears

MRI Utility in Hand Surgery

Nanomaterials for the Diagnosis and Treatment of Inflammatory Arthritis

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