Original CommunicationsThe effect of observer experience on magnetic resonance imaging interpretation and localization of triangular fibrocartilage complex lesions*,**
Section snippets
Materials and methods
Patients were identified retrospectively from the databases of 3 fellowship-trained hand surgeons covering the period of 1992 to 1997. Inclusion criterion was an MRI scan performed before surgical wrist arthroscopy. All patients meeting this criterion were included unless they met one of the following exclusion criteria: prior wrist surgery, inability to determine the anatomic location of a TFCC lesion based on review of the surgical report, or the presence of a fracture or avascular necrosis
Results
The study included a total of 49 patients with 51 wrists evaluated by MRI and arthroscopy. Thirty-six wrists had arthroscopically confirmed TFCC tears; 15 patients underwent arthroscopy without evidence of full-thickness TFCC perforation. There were 19 central lesions, 12 peripheral lesions, and 4 radial lesions. The data are summarized in Tables 1 and 2.Empty Cell Arthroscopic Findings MRI Evaluation No Tear Central Radial Peripheral Total No tear 15 0 0 1 16 Central 3
Discussion
Imaging of TFCC continues to evolve. Arthroscopy, however, is invasive, requires an anesthetic, and the total costs associated with the procedure are greater. At our institution the difference in cost between a diagnostic wrist arthroscopy and MRI of the wrist is approximately $2,000. As the experience with wrist MRI has evolved, investigators have examined the ability of MRI to detect lesions of the ulnar side of the wrist. Initial reports comparing MRI and arthrography found that MRI was
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No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
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Reprint requests: Philip E. Blazar, MD, Division of Orthopaedic Surgery, University of Kentucky, 740 South Limestone, K401 Kentucky Clinic, Lexington, KY 40536-0284.