title: Clinical tests and magnetic resonance imaging have limited diagnostic value for triangular fibrocartilaginous complex lesions.
abstract: BACKGROUND
  The diagnostic value of clinical tests and magnetic resonance (MR) imaging for the investigation of triangular fibrocartilaginous complex (TFCC) lesions is not clear due to a lack of clinical data.
  
  
  METHODS
  We retrospectively analyzed 908 patients who underwent clinical tests and arthroscopy for suspected TFCC lesions at our institution. Further, MR imaging findings concerning the TFCC were gathered. We correlated clinical tests and MR imaging findings with those obtained during arthroscopy, and we calculated sensitivity, specificity, as well as positive and negative predictive values.
  
  
  RESULTS
  In the whole cohort, the positive predictive values of all clinical tests were low, ranging from 0.53 to 0.55. The ulna grinding test had the highest sensitivity, but lowest specificity. Sensitivity and specificity of the ulnar fovea sign and magnetic resonance imaging were similar, ranging from 0.73 to 0.76, and from 0.41 to 0.44, respectively. To some degree, the diagnostic value seemed to depend on the Palmer class of TFCC lesion.
  
  
  CONCLUSIONS
  According to this study, clinical tests and MR imaging findings are of very limited diagnostic value for the diagnosis of TFCC lesions.
authors.affiliation: Department for Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Schmauss
authors.affiliation: Department for Hand, Plastic and Reconstructive Surgery, Burn Center - BG Trauma Center Ludwigshafen, Plastic and Hand Surgery of the University of Heidelberg, Heidelberg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Pöhlmann
authors.affiliation: Department for Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany.
authors.forename: J A
authors.initials: JA
authors.lastname: Lohmeyer
authors.affiliation: Department for Hand, Plastic and Reconstructive Surgery, Burn Center - BG Trauma Center Ludwigshafen, Plastic and Hand Surgery of the University of Heidelberg, Heidelberg, Germany.|Clinic for Plastic, Reconstructive and Aesthetic Surgery, ETHIANUM, Heidelberg, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Germann
authors.affiliation: Department for Hand, Plastic and Reconstructive Surgery, Burn Center - BG Trauma Center Ludwigshafen, Plastic and Hand Surgery of the University of Heidelberg, Heidelberg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Bickert
authors.affiliation: Department for Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany. kai.megerle@mri.tum.de.|Department for Hand, Plastic and Reconstructive Surgery, Burn Center - BG Trauma Center Ludwigshafen, Plastic and Hand Surgery of the University of Heidelberg, Heidelberg, Germany. kai.megerle@mri.tum.de.
authors.forename: K
authors.initials: K
authors.lastname: Megerle
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D051478:Triangular Fibrocartilage / Q000000981:diagnostic imaging*; D014954:Wrist Injuries / Q000175:diagnosis*; D055815:Young Adult
keywords: Arthroscopy; Magnetic resonance imaging; Triangular fibrocartilaginous complex; Ulna grinding test; Ulnar fovea sign; Ulnar-sided wrist pain