Fifty-four patients with wrist pain underwent both magnetic resonance imaging (MRI) and arthroscopic assessment. The MRI studies were performed using a 1.5 Tesla scanner without contrast and without a dedicated wrist coil. The MRI studies had low sensitivities for the detection of triangular fibrocartilage injuries (0.44) and scapholunate ligament injuries (0.11) when wrist arthroscopy was used as the standard of reference.
The findings in this study support an earlier report on the difficulties of assessing scapholunate ligament and triangular fibrocartilage injuries in the wrist by MRI (Johnstone et. al, JHS 22B: 714-718, 1997). Other authors, however, have reported high sensitivities for detecting injury to the triangular fibrocartilage complex when using a dedicated wrist coil (Potter et al, JBJS 79A: 1675-1684, 1997; Oneson et. al, Am J Roentgen 168: 1513-1518, 1997). A closed 1.5 Tesla MRI scanner with use of a dedicated wrist coil may provide the most complete information and should be considered when ordering an MRI of the wrist for soft-tissue injury evaluation. Other methods which may potentially improve the quality of the study include obtaining thin image slices and administering gadolinium contrast.
Journal of Hand Surgery