Abstract
Introduction and Objectives: The aim of this study was to determine sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of clinical tests and simple MRI of the wrist in the diagnosis of lesions of the fibrocartilaginous complex.
Materials and Methods: We carried out a comparative study of 30 patients in which the radio-carpal joint was operated arthroscopically between 1999 and 2006. We assessed sex, age, presence of clinical signs of fibrocartilaginous lesion, MRI results and arthroscopic findings.
Results: Amongst the patients the female sex predominated (73%), mean age was 33.3 years; there were clinical signs of fibrocartilaginous lesion in 80% of the patients, the MRI showed synovitis in 40% and fibrocartilaginous rupture in 60%. During arthroscopy, synovitis was found in 57% of cases and fibrocartilaginous rupture en 43%. MRI sensitivity was 58.3%, specificity 43.75%, PPV 38.8% and NPV 58%. Clinical exam sensitivity was 91.6%, specificity 26.6%, PPV 58% and NPV 85.7%.
Discussion and Conclusions: The clinical tests to determine fibrocartilaginous lesion have a high sensitivity but low specificity. They have a high NPV and a low NPV. Simple MRI is not reliable. Most authors recommend the use of contrast MR or high resolution MR.
The abstracts were prepared by E. Carlos Rodríguez-Merchán, Editor-in-Chief of the Spanish Journal of Orthopaedic Surgery and Traumatology (Revista Española de Cirugía Ortopédica y Traumatología). Correspondence should be addressed to him at: Sociedad Española de Cirugía Ortopédica y Traumatología, calle Fernández de los Ríos 108, 28015-Madrid, Spain
