[Triangular fibrocartilage complex and ligamentary injuries: correlation between MRI and wrist arthroscopy findings].

INTRODUCTION

wrist ligament injuries and triangular fibrocartilage complex (TFCC) lesions are common but often underdiagnosed conditions causing chronic wrist pain. The diagnostic challenge necessitates a combination of clinical examination, imaging studies, and arthroscopy, considered the gold standard. Ligament injuries, particularly scapholunate ligament (SL), and TFCC lesions account for significant wrist instability and ulnar-sided wrist pain, respectively.

MATERIAL AND METHODS

this retrospective observational study, conducted at Hospital Ángeles Pedregal, Mexico City, aimed to assess the diagnostic accuracy of wrist magnetic resonance imaging (MRI) compared to arthroscopic findings. The sample included patients with clinical suspicion of wrist ligament or TFCC lesions who underwent both wrist MRI and arthroscopy. Clinical examination maneuvers were also evaluated. The study assessed sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for each diagnostic modality.

RESULTS

arthroscopic evaluation, considered the gold standard, revealed a high prevalence of TFCC and scapholunate ligament lesions (96.6% and 96.6%, respectively). Sensitivity for TFCC lesions on MRI was 71.4%, with 100% specificity. For ligament injuries (SL, lunotriquetral, and radioscapholunate), sensitivities ranged from 21.4% to 60.7%, with 100% specificity. Clinical examination showed higher sensitivity (29.2% to 89.3%) but lower specificity (0% to 100%) compared to MRI.

CONCLUSION

wrist MRI remains the non-invasive imaging choice, although discrepancies exist between MRI and arthroscopic findings, emphasizing the need for careful interpretation. Clinical examination enhances sensitivity but lacks specificity. The study highlights the ongoing challenge in achieving optimal diagnostic accuracy for wrist ligament and TFCC lesions, emphasizing the importance of a multimodal diagnostic approach.