[Quality rating of MRI regarding TFCC lesions in the clinical practice]

MRI diagnostic is used for wrist pain diagnostic frequently. Clinical studies in specialized centers show high sensitivity and specificity concerning TFCC lesions. The aim of this study is a comparison of MRI and arthroscopy regarding TFCC lesions not in a specialized but in a common medical environment.

We retrospectively recorded all patients between January 2004 and April 2012 who went through a wrist arthroscopy and had a preoperative MRI. 401 patients were identified, 218 males and 183 females. The average age was 42.4 (12-84) years. 88 examiners of radiological practices in the region of our hospital reported the MRI results used for this research.

In 334 cases TFCC lesions could be identified during arthroscopy. MRI showed an average sensitivity of 69% and a specificity of 60%. A Palmer classification was reported through MRI in 58 cases. Most frequently, the MRI examiners reported a Palmer 1b lesion. That result could only be verified by arthroscopy in 11 cases.

Although MRI has an acceptable degree of diagnostic test accuracy in controlled clinical studies, we do not recommend the general use of MRI in diagnosis of ulnocarpal wrist pain.