Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Bernlieger, G.
Degenerative lesions of the TFCC (Triangular Fibrocartilage Complex) ¿ Sensitivity and specificity of MRI in comparison with arthroscopic intra-operative findings, in consideration of the patients¿ outcome.
[ Diplomarbeit ] Graz Medical University; 2012. pp. 122
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Glehr Mathias
- Leithner Andreas
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- Abstract:
- Background: Traumatic or degenerative lesions of the Triangular Fibrocartilage Complex (TFCC) often cause ulnar-sided wrist pain and dysfunction. The diagnosis includes clinical examination and imaging in terms of X-ray and MRI. Wrist arthroscopy is considered to be the gold standard in the diagnosis of TFCC lesions. There are controversies concerning the accuracy, sensitivity and specificity of the MRI in detecting TFCC lesions. The main aim of the study was to evaluate the significance of the MRI in the diagnosis of TFCC lesions compared to the arthroscopic findings. A further aim was the evaluation of the patients¿ outcome. Methods: 37 patients evaluated by physical examination, MRI and wrist arthroscopy because of suggested degenerative TFCC lesions in the past, were analyzed retrospectively. This analysis included the comparison of findings in MRI and arthroscopy as well as the evaluation of the patients¿ clinical outcome based on parameters such as the DASH and modified Mayo wrist score. Results: MRI showed a combined sensitivity of 81.6% (false negative findings ranging from four to seven cases) and a specificity of 100%. The average DASH score was 25.7 points and the modified Mayo wrist score showed an average result of 75.7 points. Six patients achieved an excellent, 15 a good, ten a fair and four a poor outcome regarding the modified Mayo wrist score. The average VAS (Visual analogue scale) of the affected hand at rest was 0.46, 3.97 in terms of stress. The average grip strength respectively the overall range of movement of the affected hand was 94.9%, respectively 89.3% of the opposite hand. Discussion/Conclusion: Arthroscopy provides diagnosis of TFCC lesions with the possibility of surgical treatment in one session. MRI is a helpful diagnostic tool concerning TFCC lesions, but has the disadvantage of a limited sensitivity. Although 31 of the 37 patients declared to benefit from the arthroscopy, the DASH and modified Mayo wrist score indicated comparatively inferior results. Patients with a positive ulnar variance (UV) showed an inferior outcome.