Abstract
BackgroundWrist pain is a challenge, and imaging plays an important role in the evaluation of wrist pain.PurposeAssessment of the role of ultrasonography (USG) versus magnetic resonance imaging (MRI) in the diagnosis and evaluation of wrist painResultsOut of 50 patients, 35 males (70%) and 15 females (30%) (age range 12–62 years; mean = 31.7 years) were included in the study. The sensitivity, specificity, and accuracy of MRI and USG for tendinopathy were 95%, 100%, and 97.5% and 95%, 100%, and 97.5% respectively. The sensitivity, specificity, and accuracy of MRI and USG for TFCC tear were 75%, 100%, and 87.5% and 0%, 50%, and 50% respectively. The sensitivity, specificity, and accuracy of MRI and USG for simple ganglion were 100%, 100%, and 100% and 75%, 100%, and 87.5% respectively. The sensitivity, specificity, and accuracy of MRI and USG for solid mass were 100%, 100%, and 100% and 100%, 100%, and 100% respectively. The sensitivity, specificity, and accuracy of MRI and USG for foreign body were 50%, 100%, and 75% and 100%, 100%, and 100% respectively. The sensitivity, specificity, and accuracy of MRI and USG for carpal tunnel syndrome (CTS) were 77.8%, 100%, and 88.9% and 88.9%, 100%, and 94.4% respectively. Overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of USG Vs MRI were 79.2%, 96.1%, 95.0%, 83.3%, and 88.0% and 89.8%, 98.0%, 97.8%, 90.9%, and 94.0% respectively.ConclusionUSG is near equal to MRI in the assessment of tendon abnormalities and better than MRI in the diagnosis of CTS and foreign body, but MRI is better than USG in the assessment of TFCC and in the assessment of swelling (simple ganglion) and characterization of masses.
Highlights
Wrist pain is a challenge, and imaging plays an important role in the evaluation of wrist pain.Purpose: Assessment of the role of ultrasonography (USG) versus magnetic resonance imaging (MRI) in the diagnosis and evaluation of wrist pain
USG is near equal to MRI in the assessment of tendon abnormalities and better than MRI in the diagnosis of carpal tunnel syndrome (CTS) and foreign body, but MRI is better than USG in the assessment of Triangular fibrocartilage complex (TFCC) and in the assessment of swelling and characterization of masses
In the 50 patients, MRI detected a total of 19 (38%) tendinopathy (tenosynovitis in 9 cases, stenosing tenosynovitis in 4 cases, tendinosis in 1 case, and tendon tear in 5 cases), TFCC tear in 6 cases (12%), simple ganglion in 8 cases (16%), solid mass in 3 cases (6%), foreign body in one case (2%), and CTS in 7 cases (14%)
Summary
Purpose: Assessment of the role of ultrasonography (USG) versus magnetic resonance imaging (MRI) in the diagnosis and evaluation of wrist pain. Wrist pain is traditionally classified as acute pain caused by a specific injury or as subacute/chronic pain that usually develop gradually with or without a prior traumatic event. In these cases, the differential diagnosis is wide and includes tendinopathy, tendonitis, tenosynovitis, arthritis, and ganglions [1]. When the diagnosis remains unclear, further imaging, such as plain radiography, bone scan, ultrasonography (USG), MRI can be utilized to enhance detection and evaluation of several wrist disorders, allowing for discrimination of soft tissue structures, including marrow, ligaments, tendons, cartilage, muscles, nerves, and blood vessels. It allows dynamic tendon examination which gives it a distinct advantage over MRI [4] as well as USG is ideal for
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