ASSESSING WRIST CARTILAGE: MRI OR EYEBALL

Abstract

The aim of this study was to compare arthroscopy and MRI as methods of assessing cartilage quality in the wrist.

Patients and Methods: 15 patients were identified who had undergone both wrist MRI and arthroscopy as part of their investigations for degenerative causes of wrist pain. 5 patients had Keinbock‘s disease, 6 had scapholunate advanced collapse and 4 had scaphoid non union advanced collapse. A 3 point grading system for assessing cartilage quality was devised for both arthroscopy and MRI assessing 5 articular surfaces in the wrist joint.

Results: The scores for MRI and arthroscopy were compared statistically using Kappa analysis to assess compatibility. (where 0 equates to no agreement and 1 indicates complete agreement).

The overall Kappa score was 0.43 which shows ‘moderate’ correlation between the two methods. Individual Kappa scores for the articular surfaces were lunate fossa 0.21, proximal lunate 0.62, distal lunate 0.22, proximal capitate 0.42 and scaphoid fossa 0.56.

Conclusion: Although MRI is a useful investigation, at present it cannot replace arthroscopy in measuring cartilage quality. However it does remain an important investigation in the management of such patients. As the quality of MRI scanners improves it may be possible to avoid arthroscopy as a diagnostic procedure.