[Diagnostic value of unspecific requested and implemented MRI for detecting intracarpal lesions, compared to arthroscopic findings at 217 patients].
OBJECTIVE
The purpose of this study was to evaluate the diagnostic value of MRI for detecting intracarpal lesions in clinical routine.


METHODS
In a retrospective study, we reviewed the charts of 506 patients who had undergone wrist arthroscopy in our department between May 1998 and November 2002. Out of 506 patients 217 had an MRI. The MRI was performed at 31 different radiology facilities using a number of techniques. The MRI results were compared with the arthroscopic findings, taking the arthroscopic results as a "gold standard" (sensitivity = SEN, specificity = SPE, positive predictive value = PPV, negative predictive value = NPV, accuracy = ACC).


RESULTS
The following results were found: For tears of the scapholunate ligament the avalues are SEN 18.5 %, SPE 95 %, PPV 71 %, NPV 66 %, ACC66 %. Not one of 16 tears of the lunotriquetral ligament was found by MRI.


CONCLUSIONS
In our data we found a low sensitivity for unspecific requested and implemented MRI for detecting intracarpal lesions. Therefore the indication for MRI should only be made after experienced hand surgeons have examined the wrist. In our opinion, only direct MR-arthrography is equal to arthroscopy, so that only an experienced radiologist who is familiar with this technique should perform the MRI diagnostics of the hand.
Redeker
J
J
Klinik für Plastische, Hand- und Wiederherstellungschirurgie, Medizinische Hochschule Hannover. redeker.joern@mh-hannover.de
Meyer-Marcotty
M
M
Urbanek
F
F
Hankiss
J
J
Flügel
M
M
D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D002348:Carpal Bones / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D017885:Collateral Ligaments / Q000293:injuries / Q000473:pathology; D005260:Female; D006801:Humans; D012667:Lunate Bone / Q000293:injuries / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012421:Rupture; D021361:Scaphoid Bone / Q000293:injuries / Q000473:pathology / Q000601:surgery; D012680:Sensitivity and Specificity; D013536:Suture Techniques; D051478:Triangular Fibrocartilage / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D051221:Triquetrum Bone / Q000293:injuries / Q000473:pathology / Q000601:surgery; D014954:Wrist Injuries / Q000175:diagnosis*; D055815:Young Adult