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Sunday, February 07, 1999

MRI may have clinical use for location lesion

The accuracy rate for prediction of the anatomic location of a triangular fibrocartilage complex (TFCC) lesion using magnetic resonance imaging (MRI) is high enough so that it may be of some clinical usefulness, said Philip E. Blazar, MD, assistant professor, orthopaedic surgery, University of Kentucky, co-author of poster exhibit 429 Sunday.

"Lesions of the TFCC are a common source of ulnar-sided wrist pain," Dr. Blazar said. "No physical examination maneuver has been shown to accurately predict the presence or absence of a lesion. MRI and wrist arthrography have been used to confirm the presence of a TFCC lesion, but the ability of MRI to anatomically localize lesions of the TFCC is controversial."

Fifty-one patients who underwent wrist arthroscopy and had preoperative MRI studies were included. Thirty-six patients had arthroscopically confirmed TFCC tears, and 15 patients had arthroscopy without evidence of TFCC tear. Two observers evaluated the MRI scans. One is a radiologist with an academic interest in musculoskeletal MRI; the second is a board-eligible radiologist, with no additional training in MRI or musculoskeletal radiology.

The radiologists determined if a tear was present and its anatomic location. The possible locations were categorized as central, radial and peripheral, using a modification of Palmer and Werners' classification of TFCC tears.

The accuracy rates for prediction of a TFCC tear were 83 percent and 61 percent for the two observers. The accuracy rates for prediction of the anatomic location of a TFCC lesion were 68 percent and 37 percent.

"Our data indicates that there is a difference in interpretation of these studies dependent upon the experience and training of the radiologist," Dr. Blazar said. "Accuracy rates may be superior with more standardized techniques."

In addition to Dr. Blazar, co-authors of the study are Peter S.N. Chan, MD; David J. Bozentka, MD; Donald F. Leatherwood III, MD; and Bruce J. Kneeland, MD.

1999 Academy News Feb. 7 Index A
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Last modified 07/February/1999