Role of ultrasound versus magnetic resonance imaging in evaluation of non-osseous disorders causing wrist pain

Abstract

Background: Wrist pain is a challenge, and imaging plays an important role in the evaluation of wrist pain.Purpose: Assessment of the role of ultrasonography (USG) versus magnetic resonance imaging (MRI) in the diagnosis and evaluation of wrist pain Results: Out of 50 patients, 35 males (70%) and 15 females (30%) (age range 12-62 years; mean = 31.7 years) were included in the study. The sensitivity, specificity, and accuracy of MRI and USG for tendinopathy were 95%, 100%, and 97.5% and 95%, 100%, and 97.5% respectively. The sensitivity, specificity, and accuracy of MRI and USG for TFCC tear were 75%, 100%, and 87.5% and 0%, 50%, and 50% respectively. The sensitivity, specificity, and accuracy of MRI and USG for simple ganglion were 100%, 100%, and 100% and 75%, 100%, and 87.5% respectively. The sensitivity, specificity, and accuracy of MRI and USG for solid mass were 100%, 100%, and 100% and 100%, 100%, and 100% respectively. The sensitivity, specificity, and accuracy of MRI and USG for foreign body were 50%, 100%, and 75% and 100%, 100%, and 100% respectively. The sensitivity, specificity, and accuracy of MRI and USG for carpal tunnel syndrome (CTS) were 77.8%, 100%, and 88.9% and 88.9%, 100%, and 94.4% respectively. Overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of USG Vs MRI were 79.2%, 96.1%, 95.0%, 83.3%, and 88.0% and 89.8%, 98.0%, 97.8%, 90.9%, and 94.0% respectively. Conclusion: USG is near equal to MRI in the assessment of tendon abnormalities and better than MRI in the diagnosis of CTS and foreign body, but MRI is better than USG in the assessment of TFCC and in the assessment of swelling (simple ganglion) and characterization of masses.

Diagnostic and Interventional Role of Magnetic Resonance Imaging and Ultrasound in Painful Wrist Conditions

“…Our results are incompatible with El-Deek et al [11] who reported that USG was able to identify simple ganglion in 6 of 8 (75%) and solid mass lesions in all 3 (100%) of the cases they evaluated. A lack of posterior acoustic enhancement and a lack of size allowed USG to miss two cases of simple ganglion, which was different from the current study where US didn't miss any case of ganglion cysts.…”

“…32 cases (64%) had a history of trauma. It was found that our findings agreed with those of El-Deek et al [11] who found that 32 patients (or 64%) out of 50 reported having experienced trauma in the past.…”

“…While we found no evidence of TFCC tears on ultrasonography (USG), El-Deek et al [11] found that MRI properly detects its diseases (75% sensitivity). This discrepancy may be due to the fact that MRI, the gold standard, permits assessment of soft tissue involvement, which may account for the findings of the two investigations.…”

“…In the present study, according to clinical diagnosis, the most common lesion was found in 18 cases (36%) who had TFCC lesions and fractures followed by 16 (32%) with ganglion cysts and 9 (18%) with 2 nd compartment tenosynovitis. In El-Deek et al [11] study, There were a total of 50 patients, and their diagnoses ranged from tendinopathy (40%), to TFCC tears (16%), to simple ganglions (16%), to solid masses (6%), to foreign bodies (4%), to CTS (18%). However, Singh et al [12] observed ganglion cysts were the most prevalent pathological finding, occurring in 29 patients (36 percent).…”

“…In both the Physical Medicine and Radiology Departments at Cairo University Hospitals, highfrequency linear probes of Samsung MEDISON UGEOH60 (5)(6)(7)(8)(9)(10)(11)(12)(13) were used for US tests; in 5 cases, GE Logic pro6 (7)(8)(9)(10)(11) was used instead.…”