The TFCC injuries are usually diagnosed by a coronal MRI. We have described the Float image for the diagnosis of peripheral injuries of the TFCC. In a sagital image parallel to the ulnar diaphysis and placed lateral to the ulnar fovea, we can observe the radiocubital dorsal and volar ligaments of the TFCC. A distance of more than 4mm between the dorsal edge of the meniscus and the joint capsule suggests the presence of TFCC peripheral rupture. 51 pacients were selected from all the patients who underwent wrist arthroscopy between 2006–2009. Inclusion criteria: MRI at our hospital, arthroscopy at our hospital, no presence of radial fracture. We assessed the correlation between the presence of the Float image and a TFCC injury confirmed by arthroscopy.INTRODUCTION
METHOD
To demonstrate evidence of Chronicle Compartmental Syndrome we performed a diagnostic test based on the measure of the intracompartmental pressure after stimulating their usual sportive activity. We considered a positive test when the measured an IMP>
15 mmHg after effort. We also performed a dynamometric of their grip and strength of the thumb-index forceps before and after surgery.
- From 15 to 20 mmHg of IMP after effort, 8 cases. - From 20 to 30 mmHg of IMP after effort, 11 cases. - Over 30 mmHg of IMP after effort, 13 cases. Minimal invasive surgery based on fasciotomy was performed to release compartmental pressure in flexor and extensor compartments of the forearm.
- 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 %