Jnl Wrist Surg 2018; 07(03): 267-272
DOI: 10.1055/s-0038-1629911
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Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

TFCC Injuries: Meta-Analysis and Comparison of Diagnostic Imaging Modalities

Matthew D. Treiser
Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts
,
Kayva Crawford
Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts
,
Matthew L. Iorio
Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts
Division of Plastic and Reconstructive Surgery, University of Colorado Medical Center, Aurora, Colorado
› Author Affiliations
Further Information

Publication History

03 March 2017

26 December 2017

Publication Date:
14 February 2018 (eFirst)

Abstract

Background Imaging of the triangular fibrocartilaginous complex (TFCC) remains difficult, as no single imaging modality demonstrates perfect sensitivity and specificity.

Purpose This study performs a meta-analysis of multiple previous publications to guide noninvasive imaging selection for the diagnosis of TFCC injuries.

Methods A literature search was performed and conducted. Studies were included that compared the diagnostic accuracy of magnetic resonance imaging (MRI), magnetic resonance arthrography (MRA), and computed tomography (CT)/computed tomographic arthrography (CTA) for the evaluation of TFCC injuries. All studies included either arthroscopic or open surgical findings as the “gold standard.” A meta-analysis was performed comparing the diagnostic accuracy of MRA, MRI, and CT for the detection of TFCC injuries.

Results Initial search returned 2,568 candidate articles. Studies were then reviewed and narrowed yielding a total of 28 independent studies (20 MRI, 9 MRA, 4 CT/CTA with some studies including multiple modalities) considered in the qualitative data synthesis. Pooling of the raw data in a meta-analysis demonstrated sensitivities of 0.76 (0.72–0.80), 0.78(0.70–0.84), and 0.89 (0.81–0.95) for MRI, MRA, and CT arthrogram, respectively, with specificities of 0.82 (0.77–0.86), 0.85 (0.77–0.92), and 0.89 (0.81–0.95), respectively. Additionally, across all imaging modalities, diagnostic accuracy was highest for central TFCC lesions versus peripheral lesions.

Conclusion This study represents the largest meta-analysis to date to compare multiple imaging modalities for the diagnosis of TFCC injuries. Pooled data demonstrated that CTA and MRA had statistically equivalent sensitivity and specificity for the diagnosis of TFCC injuries. Diagnostic accuracy was highest for central TFCC injuries.