The Role of Wrist Magnetic Resonance Arthrography in Diagnosing Triangular Fibrocartilage Complex Tears : Experience at King Hussein Medical Center , Jordan

Al-Hiari, Asem

doi:10.12816/0003235

Cited by 5 publications

(3 citation statements)

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“…The TFC articular disc is a biconcave structure attaching medially to the distal radius, and laterally to the ulnar styloid process via the proximal and distal laminae of the triangular ligament. The TFCC articulates between the proximal carpal row and the distal ulna [1, 2], facilitating smooth motion of the wrist by stabilizing the DRUJ and transmitting axial loads between the ulna and carpal bones [3]. …”

Section: Introductionmentioning

confidence: 99%

“…Conventional magnetic resonance imaging (MRI) is widely used for diagnosis of TFCC pathology, and demonstrates a high incidence of TFCC degeneration and tears as regions of increased signal intensity. Lesions of TFCC are accurately identified with conventional MR, shows strong agreement with arthroscopy [5], and are associated with diminished function such as grip weakness as well as ulnar sided wrist pain [2]. …”

Section: Introductionmentioning

confidence: 99%

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MR morphology of triangular fibrocartilage complex: correlation with quantitative MR and biomechanical properties

et al. 2015

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Objective To evaluate pathology of the triangular fibrocartilage complex (TFCC) using high resolution morphologic magnetic resonance (MR) imaging, and compare with quantitative MR and biomechanical properties. Materials and Methods Five cadaveric wrists (22 to 70 yrs) were imaged at 3T using morphologic (proton density weighted spin echo, PD FS, and 3D spoiled gradient echo, 3D SPGR) and quantitative MR sequences to determine T2 and T1rho properties. In eight geographic regions, morphology of TFC disc and laminae were evaluated for pathology and quantitative MR values. Samples were disarticulated and biomechanical indentation testing was performed on the distal surface of the TFC disc. Results On morphologic PD SE images, TFC disc pathology included degeneration and tears, while that of the laminae included degeneration, degeneration with superimposed tear, mucinous transformation, and globular calcification. Punctate calcifications were highly visible on 3D SPGR images and found only in pathologic regions. Disc pathology occurred more frequently in proximal regions of the disc than distal regions. Quantitative MR values were lowest in normal samples, and generally higher in pathologic regions. Biomechanical testing demonstrated an inverse relationship, with indentation modulus being high in normal regions with low MR values. The laminae studied were mostly pathologic, and additional normal samples are needed to discern quantitative changes. Conclusion These results show technical feasibility of morphologic MR, quantitative MR, and biomechanical techniques to characterize pathology of the TFCC. Quantitative MRI may be a suitable surrogate marker of soft tissue mechanical properties, and a useful adjunct to conventional morphologic MR techniques.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

MR morphology of triangular fibrocartilage complex: correlation with quantitative MR and biomechanical properties

et al. 2015

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“…Eight studies were retrospective [23][24][25][26][27][28][29][30] nine studies were prospective [31][32][33][34][35][36][37][38][39] and six studies [40][41][42][43][44][45] gave no description of the study design. Eight studies 23 25 27 31 33 36 43 45 included more than 60 participants; six of these studies 23 25 27 31 33 36 described wrist pathologies and two 43 45 described hand pathologies.…”

Section: Study Characteristicsmentioning

confidence: 99%

Diagnostic accuracy of history taking, physical examination and imaging for non-chronic finger, hand and wrist ligament and tendon injuries: a systematic review update

et al. 2020

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ObjectiveThe diagnostic work-up for ligament and tendon injuries of the finger, hand and wrist consists of history taking, physical examination and imaging if needed, but the supporting evidence is limited. The main purpose of this study was to systematically update the literature for studies on the diagnostic accuracy of tests for detecting non-chronic ligament and tendon injuries of the finger, hand and wrist.MethodsMedline, Embase, Cochrane Library, Web of Science, Google Scholar ProQuest and Cinahl were searched from 2000 up to 6 February 2019 for identifying studies. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 checklist, and sensitivity (Se), specificity (Sp), accuracy, positive predictive value (PPV) and negative predictive value (NPV) were extracted.ResultsNone of the studies involved history taking. Physical examination, for diagnosing lesions of the triangular fibrocartilage complex (TFCC), showed Se, Sp, accuracy, PPV and NPV ranging from 58% to 90%, 20% to 69%, 56% to 73%, 53% to 71% and 55% to 65%, respectively. Physical examination in hand and finger injuries the Se, Sp, accuracy, PPV and NPV ranged from 88% to 99%, 75% to 100%, 34% to 88%, 91% to 100% and 75% to 95%, respectively. The accuracy of MRI with high-resolution (3 T) techniques for TFCC and interosseous ligaments of the proximal carpal row ranged from 89% to 91% and 75% to 100%, respectively. The accuracy of MRI with low-resolution (1.5 T) techniques for TFCC and interosseous ligaments of the proximal carpal row ranged from 81% to 100% and 67% to 95%, respectively.ConclusionsThere is limited evidence on the diagnostic accuracy of history taking and physical examination for non-chronic finger, hand and wrist ligament and tendon injuries. Although some imaging modalities seemed to be acceptable for the diagnosis of ligament and tendon injuries in the wrist in patients presenting to secondary care, there is no evidence-based advise possible for the diagnosis of non-chronic finger, hand or wrist ligament and tendon injuries in primary care.

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Carpal angles as measured on CT and MRI: can we simply translate radiographic measurements?

et al. 2014

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The Role of Wrist Magnetic Resonance Arthrography in Diagnosing Triangular Fibrocartilage Complex Tears : Experience at King Hussein Medical Center , Jordan

Cited by 5 publications

References 0 publications

MR morphology of triangular fibrocartilage complex: correlation with quantitative MR and biomechanical properties

MR morphology of triangular fibrocartilage complex: correlation with quantitative MR and biomechanical properties

Diagnostic accuracy of history taking, physical examination and imaging for non-chronic finger, hand and wrist ligament and tendon injuries: a systematic review update

Carpal angles as measured on CT and MRI: can we simply translate radiographic measurements?

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