nach oben

Archives of Orthopaedic and Trauma Surgery

Erschienen in:

10.01.2022 | Handsurgery

Diagnostic accuracy of wrist MRI in comparison to wrist arthroscopy regarding TFCC lesions in clinical practice

verfasst von: C. K. Spies, F. Unglaub, T. Bruckner, L. Müller, P. Eysel, J. Rau

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 5/2022

Einloggen, um Zugang zu erhalten

Abstract

Introduction

The purpose of this study was to arthroscopically verify MRI diagnostic accuracy for triangular fibrocartilage complex (TFCC) lesions in a regular clinical environment.

Methods

A total of 859 patients' data with both preoperative MRI of the wrist and additional wrist arthroscopy were retrospectively reviewed. Two board-certified hand surgeons and one orthopaedic surgeon executed wrist arthroscopy, whereas more than 100 radiologists examined the MRI of the wrist. The accordance of TFCC lesion classification using MRI in comparison to wrist arthroscopy and diagnostic precision of the former depending on technical details were evaluated.

Results

Diagnostic accuracy of MRI for TFCC lesions is poor in comparison to wrist arthroscopy as the reference standard. Technical specifications for MRI of the wrist are heterogeneous among the radiologists. These parameters have not improved accuracy of TFCC evaluation at large.

Conclusion

The accuracy of MRI in a regular clinical environment still remains inferior to wrist arthroscopy for detection of TFCC lesions. Development of a standard MRI protocol may be implemented on a regular basis and application of the Palmer classification for TFCC lesion should be sought.

Kirchberger MC et al (2015) Update TFCC: histology and pathology, classification, examination and diagnostics. Arch Orthop Trauma Surg 135:427–437. https://doi.org/10.1007/s00402-015-2153-6CrossRefPubMed

Jui-Tien S, Yao-Tung H, Hung-Maan L, Chuan-Ming T, Ming-Chung C (2000) Chronic triangular fibrocartilage complex tears with distal radioulna joint instability: a new method of triangular fibrocartilage complex reconstruction. J Orthop Surg (Hong Kong) 8(1):1–8. https://doi.org/10.1177/230949900000800102CrossRef

Spies CK, Langer M, Müller LP, Oppermann J, Löw S, Unglaub F (2018) Anatomy and biomechanics of the distal radioulnar joint. Orthopade 47:621–627. https://doi.org/10.1007/s00132-018-3589-5CrossRefPubMed

Palmer AK (1990) Triangular fibrocartilage disorders: injury patterns and treatment. Arthrosc J Arthrosc Relat Surg 6:125–132. https://doi.org/10.1016/0749-8063(90)90013-4CrossRef

Mikić ZD (1978) Age changes in the triangular fibrocartilage of the wrist joint. J Anat 126:367–384PubMedPubMedCentral

Palmer AK (1989) Triangular fibrocartilage complex lesions: a classification. J Hand Surg 14:594–606. https://doi.org/10.1016/0363-5023(89)90174-3CrossRef

Jawed A, Ansari MT, Gupta V (2020) TFCC injuries: how we treat? J Clin Orthop Trauma 11:570–579. https://doi.org/10.1016/j.jcot.2020.06.001CrossRefPubMedPubMedCentral

Schmauss D, Pöhlmann S, Lohmeyer JA, Germann G, Bickert B, Megerle K (2016) Clinical tests and magnetic resonance imaging have limited diagnostic value for triangular fibrocartilaginous complex lesions. Arch Orthop Trauma Surg 136:873–880. https://doi.org/10.1007/s00402-016-2441-9CrossRefPubMed

Treiser M, Crawford K, Iorio M (2018) TFCC injuries: meta-analysis and comparison of diagnostic imaging modalities. J Wrist Surg 7:267–272. https://doi.org/10.1055/s-0038-1629911CrossRefPubMedPubMedCentral

10.

Ochman S, Wieskötter B, Langer M, Vieth V, Raschke MJ, Stehling C (2017) High-resolution MRI (3T-MRI) in diagnosis of wrist pain: is diagnostic arthroscopy still necessary? Arch Orthop Trauma Surg 137:1443–1450. https://doi.org/10.1007/s00402-017-2747-2CrossRefPubMed

11.

Johnstone DJ, Thorogood S, Smith WH, Scott TD (1997) A comparison of magnetic resonance imaging and arthrosopy. J Hand Surg 22:714–718. https://doi.org/10.1016/S0266-7681(97)80431-7CrossRef

12.

Gologan RE, Koeck M, Suda AJ, Obertacke U (2019) 10-year outcome of dislocated radial fractures with concomitant intracarpal lesions as proven by MRI and CT. Arch Orthop Trauma Surg 139:877–881. https://doi.org/10.1007/s00402-019-03186-8CrossRefPubMed

13.

Schmitt R, Grunz JP, Luetkens K, Haas-Lützenberger E, Hesse N (2021) The ulnocarpal complex: new clinical and radiological considerations. Radiologe 61:343–350. https://doi.org/10.1007/s00117-021-00824-4CrossRefPubMed

14.

Mannil L et al (2016) Arthroscopic treatment for ulnar-sided TFCC-tears. Eur J Trauma Emerg Surg 4:29–35. https://doi.org/10.1007/s00068-015-0593-xCrossRef

15.

Bille B, Harley B, Cohen H (2007) A comparison of CT arthrography of the wrist to findings during wrist arthroscopy. J Hand Surg Am 32:834–841. https://doi.org/10.1016/j.jhsa.2007.04.005CrossRefPubMed

16.

Slutsky DJ (2012) Current innovations in wrist arthroscopy. J Hand Surg Am 37:1932–1941. https://doi.org/10.1016/j.jhsa.2012.06.028CrossRefPubMed

17.

Spies CK et al (2021) Therapy of the instabile distal radioulnar joint. Handchirurgie Scan 10:215–235. https://doi.org/10.1007/s00132-018-3576-xCrossRef

18.

Spies CK, Prommersberger KJ, Langer M, Müller LP, Hahn P, Unglaub F (2015) Instability of the distal radioulnar joint: treatment options for ulnar lesions of the triangular fibrocartilage complex. Unfallchirurg 118:701–717. https://doi.org/10.1007/s00113?015?0044?5CrossRefPubMed

19.

Löw S, Spies CK, Unglaub F, Oppermann J, Langer M, Erne H (2018) Diagnosis and treatment of degenerative disc lesions of the wrist. Orthopade 47:670–676. https://doi.org/10.1007/s00132-018-3551-6CrossRefPubMed

20.

Spies CK et al (2021) Long-term outcome after arthroscopic debridement of Palmer type 2C central degenerative lesions of the triangular fibrocartilage complex. Arch Orthop Trauma Surg 141:1807–1814. https://doi.org/10.1007/s00402-021-03918-9CrossRefPubMed

21.

Kwon YW, Park JH, Choi IC, Lee JS, Park JW (2020) Revisional triangular fibrocartilage complex (TFCC) repair using arthroscopic one-tunnel transosseous suture: preliminary results. Arch Orthop Trauma Surg. https://doi.org/10.1007/s00402-020-03613-1CrossRefPubMed

22.

Pillukat T, Fuhrmann RA, Windolf J, van Schoonhoven J (2016) Arthroscopically assisted transcapsular refixation of the triangular fibrocartilage complex of the wrist. Oper Orthop Traumatol 28:233–250. https://doi.org/10.1007/s00064-016-0466-4CrossRefPubMed

23.

Schmelzer-Schmied N (2016) Arthroscopic refixation of TFCC by bone screw anchor. Oper Orthop Traumatol 28:251–262. https://doi.org/10.1007/s00064-01604557CrossRefPubMed

24.

Haims AH, Schweitzer ME, Morrison WB, Deely D, Lange RC, Osterman AL, Bednar JM, Taras JS, Culp RW (2003) Internal derangement of the wrist: indirect MR arthrography versus unenhanced MR imaging. Radiology 227:701–707. https://doi.org/10.1148/radiol.2273020398CrossRefPubMed

25.

Boer BC, Vestering M, van Raak SM, van Kooten EO, Huis in ‘t Veld R, Vochteloo AJH (2018) MR arthrography is slightly more accurate than conventional MRI in detecting TFCC lesions of the wrist. Eur J Orthop Surg Traumatol 28:1549–1553. https://doi.org/10.1007/s00590-018-2215-xCrossRefPubMedPubMedCentral

26.

Rein S et al (2021) Degeneration of the articular disc in the human triangular fibrocartilage complex. Arch Orthop Trauma Surg 141:699–708. https://doi.org/10.1007/s00402-021-03795-2CrossRefPubMed

27.

Oneson SR, Ti ME, Scales LM, Erickson S (1997) MR imaging diagnosis of triangular fibrocartilage pathology with arthroscopic correlation. Am J Roentgenol. https://doi.org/10.2214/ajr.168.6.9168716CrossRef

28.

Chung K, Zimmerman N (1996) Arthrography versus arthroscopy. J Hand Surg Am 21:591–594. https://doi.org/10.1016/S0363-5023(96)80008-6CrossRefPubMed

29.

Atzei A, Luchetti R (2011) Foveal TFCC tear classification and treatment. Hand Clin 27:263–272. https://doi.org/10.1016/j.hcl.2011.05.014CrossRefPubMed

30.

Unglaub F, Müller LP, Oppermann J, Hahn P, Spies CK (2014) Push-off needle test for traumatic triangular fibrocartilage complex lesions. J Hand Surg Am 39:1448–1449. https://doi.org/10.1016/j.jhsa.2014.03.026CrossRefPubMed

Titel: Diagnostic accuracy of wrist MRI in comparison to wrist arthroscopy regarding TFCC lesions in clinical practice
verfasst von: C. K. Spies
F. Unglaub
T. Bruckner
L. Müller
P. Eysel
J. Rau
Publikationsdatum: 10.01.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 5/2022
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-021-04329-6

Surgical treatment of the bony mallet thumb: a case series and literature review

Open Access
Handsurgery

Risk factors for failure after cementless femoral revision THA: a consecutive series of 105 cases

Orthopaedic Surgery

Perioperative complications in osteotomies around the knee: a study in 858 cases

Orthopaedic Surgery

Correlation of factors affecting correction of meniscal extrusion and outcome after medial meniscus root repair

Arthroscopy and Sports Medicine

A single-surgeon experience in reconstruction of femoro-acetabular offset and implant positioning in direct anterior approach and anterolateral MIS approach with a curved short stem

Open Access
Hip Arthroplasty

A systematic review about long-term results after meniscus repair

Open Access
Arthroscopy and Sports Medicine

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie erweitert durch Fallbeispiele, Videos und Abbildungen. Zur Fortbildung und Wissenserweiterung, verfasst und geprüft von Expertinnen und Experten der Gesellschaft für Arthroskopie und Gelenkchirurgie (AGA).

Jetzt entdecken!

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Nackenschmerzen nach Bandscheibenvorfall: Muskeltraining hilft!

15.01.2025
Nackenschmerzen
Nachrichten

Bei hartnäckigen Schmerzen aufgrund einer zervikalen Radikulopathie schlägt ein Team der Universität Istanbul vor, lokale Steroidinjektionen mit einem speziellen Trainingsprogramm zur Stabilisierung der Nackenmuskulatur zu kombinieren.

Die elektronische Patientenakte kommt: Das sollten Sie jetzt wissen

12.01.2025
Elektronische Patientenakte
Nachrichten

Am 15. Januar geht die „ePA für alle“ zunächst in den Modellregionen an den Start. Doch schon bald soll sie in allen Praxen zum Einsatz kommen. Was ist jetzt zu tun? Was müssen Sie wissen? Wir geben in einem FAQ Antworten auf 21 Fragen.

Was sich Menschen mit Frozen Shoulder wünschen

10.01.2025
Schultersteife
Nachrichten

Die Capsulitis adhaesiva des Glenohumeralgelenks, auch als Frozen Shoulder bezeichnet, belastet die Betroffenen weit über die körperlichen Beschwerden hinaus, wie eine italienische Studie ergeben hat.

Restriktive Sauerstoffgabe ohne Vorteil bei schwerem Trauma

09.01.2025
Traumatologische Notfallmedizin
Nachrichten

Ob schwer verletzte Personen besser restriktiv oder liberal mit Sauerstoff versorgt werden sollten, hat die Arbeitsgruppe der TRAUMOX2-Studie untersucht – mit klarem Ergebnis.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Diagnostic accuracy of wrist MRI in comparison to wrist arthroscopy regarding TFCC lesions in clinical practice