Diagnostic Accuracy of Magnetic Resonance Arthrography and its Correlation with Arthroscopy in the Detection of Lesions Triangular Fibrocartilaginous Complex and Intrinsic Ligaments in the Wrist

Abstract

Objectives: To assess the diagnostic validity and reliability of magnetic resonance arthrography in identifying the lesion of triangular intrinsic wrist ligaments and fibrocartilaginous complex based on arthroscopy as reference standard and preferred modality of imaging.

Methodology: This was a retrospective validation study that was carried out at the Radiology department of PESSI (Punjab Employees Social Security) Hospital, Islamabad, between April 2019 and September 2022. A total of 11 patients with an age range 21-58 years, lesions of the triangular fibrocartilaginous complex (TFCC), and MR arthrography were included. MR arthrography images of the wrist were evaluated to assess the integrity of the intrinsic wrist ligaments, including those of the TFCC, scapholunate, and lunotriquetral ligament. MR arthrography injection was performed into the wrist joint, likely to help visualize the ligaments and other structures within the joint. The injection was performed under fluoroscopic guidance, and the size of the needle used for the injection was 20-24G. The data collected from the MR arthrograms and arthroscopy was analyzed using SPSS v 23.

Results: The patient’s mean age was 40.0±12.31 years. Out of 11 patients, there were 6 (55.5%) males and 5 (45.5%) females. Sensitivity of MR arthrography is 71.4% and specificity that of 75% for detecting TFCC defects, and a 100% sensitivity and 85.7% specificity for diagnosing intrinsic ligament defects. MR arthrography had an overall accuracy of 73% for detecting TFCC, while the overall accuracy for detecting intrinsic ligament defects was 90.9%.

Conclusion: MR arthrography was an adequate diagnostic tool for detecting defects of the intrinsic ligaments and the TFCC of the wrist when compared to diagnostic arthroscopy.