COMPARED UTILITY OF ULTRASOUND VS. MRI AT DIAGNOSIS FOR THE RUPTURE OF THE TFCC WITH ARTHROSCOPICAL CONFIRMATION

Abstract

Introduction. Prospective comparative study to evaluate the efficacy of the ultrasound diagnosis vs MRI in rupture of the Triangular fibrocartilage with arthroscopic confirmation.

Material and methods. 55 patients presenting clinical wrist pain were studied from January’2004 untill september 2006. Our patient selection was composed by 30 men and 25 women, and the age range was 17 to 70 years old. 40 were Right-handed and 15 Left-Handed. Patients presented wrist pain related to several disorders. Our protocol included Sonography with a 11–MHz linear array probe using real-time compound spatial imaging and 1T-MRI studies. Wrist arthroscopy was performed in all of them.

Results. 67 % of our patients presented Triangular fibrocartilage rupture at arthroscopy. The distribution of our patients related to the complementary tests was:

• - Arthroscopy (+) 37 cases out of 50 (64%)

• - Ultrasound (+) 21 out of 37 (+ Art))

• - MRI (+) 22 out of 37 (+ Art)

According to this results we can easily calculate the sensibility/specificity and PPV/PNV of both tests:

• - Ultrasound Sensibility/Specificity: 58,3 %/36,8 %

• - MRI Sensibility/Specificity: 61 %/47 %

• - Ultrasound PPV/PNV: 58 %/31,8 %

• - MRI PPV/PNV: 68 %/37 %

Conclusions. Due to the results we obtained in our study, we can consider ultrasound as sensible and specific as MRI at diagnosis for the rupture of the Triangular fibrocartilage. In our opinion we conclude that neither MRI nor ultrasound results should be considered satisfactory for a proper diagnosis. This could be sorted out by the use of more resolutive MRI and ultrasound equipments.