MR Evaluation of Triangular Fibrocartilage Complex Tears in the Wrist

Cerofolini, E; Luchetti, Riccardo; Pederzini, Luigi Adriano; Soragni, O.; Colombini, R; DʼAlimonte, P; Romagnoli, Renato

doi:10.1097/00004728-199011000-00018

Cited by 71 publications

(28 citation statements)

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“…Unfortunately, MR has a wide range of accuracy in detecting TFCC, SLIL, and LTIL tears. [11][12][13][14][15][16][17][18][19][20][21][22] With reported sensitivities as low as 44% for TFCC tears and 11% for STIL tears, some authors believe it to be too unreliable for routine use. 17 More recently, MRA has been introduced and determined to be more accurate than plain MR, but substantial problems exist with this particular modality.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8][9][10] Magnetic resonance (MR) is another modality that has been used to evaluate wrist pathology, but the sensitivity and specificity of MR is quite variable. [11][12][13][14][15][16][17][18][19] Magnetic resonance arthrogram (MRA) has been introduced more recently and has shown improved accuracy over plain MR. 20 -23 Computed tomography (CT) arthrogram of the wrist is a relatively new technique that can combine the detailed CT view of bony anatomy with a clear picture of the ligamentous structures of the wrist. 24 -26 The contrast medium outlines cartilage and ligamentous structures, and the thin cuts of the slices allow for vastly improved detail when compared with plain arthrogram.…”

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confidence: 99%

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A Comparison of CT Arthrography of the Wrist to Findings During Wrist Arthroscopy

Bille

Harley

Cohen

2007

The Journal of Hand Surgery

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

A Comparison of CT Arthrography of the Wrist to Findings During Wrist Arthroscopy

Bille

Harley

Cohen

2007

The Journal of Hand Surgery

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“…Table 3. Methodologic quality of the included studies Cerofolini et al [6] Cooney [8] Dwek et al [9] Iordache et al [10] Levinsohn and Palmer [13] Mahmood et al [15] Tanaka et al [24] Weiss et al [28] Yamamoto et al [29] Selection (1) Representativeness of the exposed cohort Yamamoto et al [29] Outcome ( …”

Section: Appendixmentioning

confidence: 99%

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

Chan

Teunis

Ring

2014

Clin Orthop Relat Res

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Background Triangular fibrocartilage complex abnormalities seem to be more common with age, but the degree to which this is so, and the degree to which the presence of an abnormality is associated with symptoms, are topics of controversy. Questions/purposes We wished to perform a systematic review to determine the prevalence of triangular fibrocartilage complex abnormalities, and to determine if the prevalence of abnormalities are greater with increasing age. In addition, we stratified age groups based on symptoms. Methods We searched MEDLINE, EMBASE, and the Cochrane Library through August 15, 2013. Studies that reported triangular fibrocartilage complex abnormalities by age were included. Fifteen studies including 977 wrists met our criteria and reported a total of 368 (38%) triangular fibrocartilage complex abnormalities. Eight studies included symptomatic patients; the remainder studied cadavers (six studies) or asymptomatic volunteers (one study). Patients were divided into four age groups (\30, 30-49, 50-69, and 70 years and older) for pooled analysis, comparing the proportions of patients with and without abnormalities between groups using chi-square analysis. We also evaluated the proportions after stratifying each age group by symptoms. Results Overall, the prevalence of triangular fibrocartilage complex abnormalities increased with age, from 27% (80/301) in patients younger than 30 years to 49% (130/ 265) in patients 70 years and older (p \ 0.001), odds ratio (OR), 2.7, 95% CI, 1.9-3.8 (p \ 0.001). In asymptomatic patients, triangular fibrocartilage complex prevalence abnormality increased from 15% (24/159) to 49% (129/ 263) in the same age groups (p \ 0.001), OR, 5.4, 95% CI, 3.3-8.9 (p \ 0.001). For symptomatic patients prevalence ranged from 39% (56/142) to 70% (14/20) in patients between 50 and 69 years old (p\0.034), OR, 3.6, 95% CI, 1.3-9.9 (p \ 0.014). Conclusion Triangular fibrocartilage complex abnormalities are common in symptomatic and asymptomatic wrists, and they are increasingly common with age. As in all situations where abnormalities are so common that they may be incidental, we need (1) a reliable and accurate method for determining whether these abnormalities are the cause of symptoms; and (2) evidence that treatment of these abnormalities improves symptoms better than placebo.

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“…This supports the findings of other authors who report MRI being approximately 80% sensitive for TFCC tears. 33,38 We believe that, in a symptomatic patient with isolated foveal tenderness and a normal MRI who has failed appropriate conservative treatment, a TFCC tear should be suspected. We do not believe that this necessitates arthroscopy in all cases, as the natural history of ulnar-sided wrist pain is yet to be fully delineated.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Treatment of Peripheral Triangular Fibrocartilage Complex Tears With the Deep Fibers Intact

Wysocki

Richard

Crowe

et al. 2012

The Journal of Hand Surgery

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MR Evaluation of Triangular Fibrocartilage Complex Tears in the Wrist

Cited by 71 publications

References 0 publications

A Comparison of CT Arthrography of the Wrist to Findings During Wrist Arthroscopy

A Comparison of CT Arthrography of the Wrist to Findings During Wrist Arthroscopy

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

Arthroscopic Treatment of Peripheral Triangular Fibrocartilage Complex Tears With the Deep Fibers Intact

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