Chronic wrist pain: evaluation with high-resolution MR imaging

Area of Science:

• Orthopedic imaging
• Musculoskeletal radiology

Background:

• Chronic wrist pain affects many individuals, often stemming from injuries to the triangular fibrocartilage complex (TFCC) and wrist ligaments.
• Accurate diagnosis is crucial for effective treatment and management of wrist pain.

Purpose of the Study:

• To evaluate the diagnostic performance of magnetic resonance (MR) imaging in assessing the TFCC and intrinsic/extrinsic wrist ligaments in patients with chronic wrist pain.
• To compare MR imaging findings with arthrography and surgical outcomes (arthroscopy/arthrotomy).

Main Methods:

• MR imaging was performed on 43 patients with chronic wrist pain.
• Correlative imaging included arthrography in 41 patients and arthroscopy or arthrotomy in 23 patients.
• Diagnostic accuracy metrics (sensitivity, specificity, accuracy) were calculated for MR imaging against arthrography and surgical findings.

Main Results:

• MR imaging effectively visualized normal anatomy of the TFCC and wrist ligaments.
• MR imaging demonstrated high accuracy in detecting TFCC tears (sensitivity 1.0, specificity 0.93 vs. arthrography; 0.89, 0.92 vs. surgery).
• MR imaging also accurately identified tears in intercarpal ligaments (especially scapholunate), cartilage defects, and distal radioulnar joint subluxations.

Conclusions:

• MR imaging is a highly effective non-invasive tool for diagnosing wrist injuries in patients presenting with chronic wrist pain.
• It provides accurate assessment of the TFCC, intrinsic and extrinsic ligaments, and associated pathologies, aiding in treatment planning.