Fabrice Stephane Thevenin MD, Presenter: Nothing to Disclose

Jean Luc Drapé, Abstract Co-Author: Nothing to Disclose

Henri Guerini MD, Abstract Co-Author: Nothing to Disclose

Nicolas Theumann MD, Abstract Co-Author: Nothing to Disclose

Laurent Sarazin MD, Abstract Co-Author: Nothing to Disclose

Alain Chevrot MD, Abstract Co-Author: Nothing to Disclose

To evaluate the diagnostic value of direct tri-compartmental MR arthrography of traumatic lesions of the triangular fibrocartilage complex(TFCC) according to Palmer’s classification.

A multicentric prospective study included 29 patients who underwent a direct tri-compartmental MR-arthrography of the wrist and an arthroscopy. Fat suppressed 1.2 to 1.4 mm thick contiguous coronal, sagittal and axial T1-weighted 3D gradient echo slices were acquired. These cases were reviewed by three experienced musculoskeletal radiologists, who were unaware of the arthroscopic findings. Each lesion was classified according to Palmer’s classification and correlated to the arthroscopic findings. Inter and intra-observer reproducibilities were assessed.

16 traumatic injuries of the TFCC (eight 1A, seven 1B and one 1D) were identified at arthroscopy. MR-arthrography depicted tears of the TFCC with global sensitivities, specificities, and accuracies of 69%-100%, 81%-100%, and 86-100% respectively. MR-arthrography showed a correct staging according to Palmer’s classification with sensitivities, specificities, and accuracies of 67%-89%, 99%-100%, and 97-99% respectively. Imaging accuracies were excellent for Palmer 1A and 1B injuries of the TFCC. The high depiction of 1B injuries was based on the comparison of sagittal and coronal thin slices. MR-arthrography demonstrated good and very good agreement among the three observers (Kappa 0.64 to 0.93).

Direct tri-compartmental MR-arthrography with 3D sequences is well correlated with Palmer 1A, 1B and 1D injuries of the TFCC and showed a good reproducibility.

Thevenin, F, Drapé, J, Guerini, H, Theumann, N, Sarazin, L, Chevrot, A, Traumatic Injuries of the Triangular Fibrocartilage Complex: Value of MR Arthrography Compared to Palmer’s Classification.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4415831.html