Schmauss D, Pöhlmann S, Lohmeyer J A, Germann G, Bickert B, Megerle K
Department for Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany.
Department for Hand, Plastic and Reconstructive Surgery, Burn Center - BG Trauma Center Ludwigshafen, Plastic and Hand Surgery of the University of Heidelberg, Heidelberg, Germany.
Arch Orthop Trauma Surg. 2016 Jun;136(6):873-80. doi: 10.1007/s00402-016-2441-9. Epub 2016 Mar 11.
The diagnostic value of clinical tests and magnetic resonance (MR) imaging for the investigation of triangular fibrocartilaginous complex (TFCC) lesions is not clear due to a lack of clinical data.
We retrospectively analyzed 908 patients who underwent clinical tests and arthroscopy for suspected TFCC lesions at our institution. Further, MR imaging findings concerning the TFCC were gathered. We correlated clinical tests and MR imaging findings with those obtained during arthroscopy, and we calculated sensitivity, specificity, as well as positive and negative predictive values.
In the whole cohort, the positive predictive values of all clinical tests were low, ranging from 0.53 to 0.55. The ulna grinding test had the highest sensitivity, but lowest specificity. Sensitivity and specificity of the ulnar fovea sign and magnetic resonance imaging were similar, ranging from 0.73 to 0.76, and from 0.41 to 0.44, respectively. To some degree, the diagnostic value seemed to depend on the Palmer class of TFCC lesion.
According to this study, clinical tests and MR imaging findings are of very limited diagnostic value for the diagnosis of TFCC lesions.
由于缺乏临床数据，临床检查和磁共振（MR）成像对三角纤维软骨复合体（TFCC）损伤的诊断价值尚不明确。
我们回顾性分析了在我院因疑似TFCC损伤而接受临床检查和关节镜检查的908例患者。此外，收集了有关TFCC的MR成像结果。我们将临床检查和MR成像结果与关节镜检查结果进行关联，并计算敏感性、特异性以及阳性和阴性预测值。
在整个队列中，所有临床检查的阳性预测值都很低，范围在0.53至0.55之间。尺骨研磨试验敏感性最高，但特异性最低。尺骨凹征和磁共振成像的敏感性和特异性相似，分别在0.73至0.76和0.41至0.44之间。在某种程度上，诊断价值似乎取决于TFCC损伤的帕尔默分类。
根据本研究，临床检查和MR成像结果对TFCC损伤的诊断价值非常有限。
