High-resolution ultrasound versus MRI in evaluation of triangular fibrocartilage complex

Introduction
Pain on the ulnar side of the wrist is a complex diagnostic dilemma and the triangular fibrocartilage complex provides much needed support to the wrist, and extensor carpi ulnaris (ECU) tendon is part of the complex. The most important investigations to diagnose wrist pathologies include ultrasound, computed tomography, and MRI.


Aim
The aim of this study is to evaluate the diagnostic performance of both ultrasonography and MRI findings in ECU tendon part of triangular fibrocartilage complex.


Patients and methods
This control study was carried out on 50 patients with ulnar side wrist pain. The study was conducted in the period from May 2018 to May 2020 at the Radiology Department and approved by the Ethics Committee, and all patients gave their informed consent before inclusion in the study. Results were collected then analyzed using a specialized computer statistical program.


Results
MRI detected ECU injury in 13 joints, whereas ultrasound detected it in 17 joints. They both agreed in 46 joints. MRI missed four joints with ECU injury detected by ultrasound. Statistical analysis of the results showed a highly significant agreement (P value) between both MRI and ultrasound in the detection of ECU injury.


Conclusion
Both MRI and musculoskeletal ultrasound have complimentary roles in the evaluation of different causes of ulnar sided wrist pain. Musculoskeletal ultrasound is highly recommended for the examination of tendons and inflammatory changes of the wrist.