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.

Purpose: To compare clinical results and MR images of different arthroscopic techniques used in our hospital (mosaic-plasty, microfractures, fixation or excision and curettage).

Materials and methods: This was a retrospective study of 40 cases of knee ostochondritis in adolescent patients operated in our hospital between 1992 and 2005 assessed by location, sex, surgical technique and MRI.

Results: Mean age at surgery was 16 years of age. The most frequent location was the medial condyle. The right knee was involved in 74% of cases. Mosaic-plasty was carried out in 26% of cases, microfractures in 42%, excision and curettage in 26% and fragment osteosynthesis in 6%. Mean follow-up was 7 years and in the microfracture group there were 25% poor results and 75% excellent results. The results were poor in 100% of the group that underwent fragment osteosynthesis. In the excision and curettage group there were 50% good results and 50% excellent results. In the mosaic-plasty group there were excellent results in 100% of the patients. The MRI showed incorporation and a normal profile of the subchondral surface in all the patients of the group that underwent mosaic-plasty. In the group of patients with microfractures there was cartilage in the microfractured area in 75% of the patients. In fragment osteosynthesis there was MRI evidence of non-union in 100% of cases. In the excision and curettage group there was only partial regeneration in 100% of cases.

Conclusions: In comparison with the other techniques described, better outcomes are seen when mosaic-plasty is the treatment used in advanced stages of knee osteochondritis in adolescent patients.