Diagnostic Accuracy of 3T Magnetic Resonance Imaging and Arthroscopy in Triangular Fibrocartilage Complex Injury

Abstract Introduction: The advances in the understanding of wrist instability have enhanced the need for improved diagnostic modalities. 3T magnetic resonance imaging (MRI) with a small joint coil has emerged as a promising tool in determining ligamentous wrist injuries. Although arthroscopy remains the gold standard for diagnosis, the economics of the procedure, health insurance penetrance, and indemnity concerns, a noninvasive diagnostic tool with high accuracy is the need of the hour. Materials and Methods: Here, we have compared the accuracy of a 3T MRI for the diagnosis of triangular fibrocartilage complex (TFCC) tears against diagnostic wrist arthroscopy. Results: We found that 3T MRI with small joint coils has high sensitivity and specificity in the diagnosis of foveal avulsions of TFCC. By virtue of direct visualization, arthroscopy has the ability to differentiate scar, enema, and/or hematoma from an intact ligament as compared to MRI. Conclusion: Therefore, a good quality MRI (3T MRI, small joint coil, taken in proper plane and position with thin cuts) would improve the likelihood of an accurate diagnosis and reduce the burden on the health-care system.