Rahma Farghaly Aly, Marwa Ibrahim Fahmy, Muhammad Gamal Abd El Atty, Samar Ramzy Ragheb
These findings indicate that SEL may represent a promising adjunctive imaging modality for the early assessment of TFCC injuries, particularly in settings where MRI availability is limited. So incorporating SEL in the diagnostic workflow could help stratify patients, identifying those who may benefit from more advanced imaging modalities such as magnetic resonance arthrography (MRA) or diagnostic arthroscopy for further evaluation and confirmation. This approach may enhance diagnostic accuracy while minimizing unnecessary invasive procedures.
BACKGROUND: The triangular fibrocartilage complex (TFCC) is a key fibrocartilaginous and ligamentous structure located on the ulnar side of the wrist. It plays a crucial role in separating the ulnocarpal joint from the distal radioulnar joint (DRUJ) and is essential for stabilizing the DRUJ. In addition to maintaining joint stability, the TFCC also functions as a shock absorber, distributing axial loads transmitted through the ulnar aspect of the wrist.
OBJECTIVE: To evaluate the diagnostic utility of high resolution ultrasound and strain elastography in detecting TFCC injuries, focusing primarily on the articular disc, in comparison to MRI using sensitive sequences.
PATIENTS AND METHODS: This study is cross sectional study conducted at the US Radiology Unit; Radiology Department, Ain Shams University Hospitals (ASUH), and the magnetic resonance imaging (MRI) Radiology Unit; Radiology Department, ASUH on 26 patients included in this study. Patients who came to the orthopaedic hand clinic presented with ulnar side wrist pain.
RESULTS: The results of the study demonstrated a strong correlation between strain elastography (SE) and MRI in the detection of TFCC injuries. Quantitative Sonoelastography (SEL) measurements showed consistent patterns of altered tissue stiffness in patients with confirmed TFCC pathology on MRI, suggesting that SEL can reliably reflect the biomechanical changes associated with TFCC damage. Statistical analysis revealed a significant positive correlation between SEL findings and MRI-detected abnormalities, supporting the potential of SEL as a complementary diagnostic modality.
CONCLUSION: These findings indicate that SEL may represent a promising adjunctive imaging modality for the early assessment of TFCC injuries, particularly in settings where MRI availability is limited. So incorporating SEL in the diagnostic workflow could help stratify patients, identifying those who may benefit from more advanced imaging modalities such as magnetic resonance arthrography (MRA) or diagnostic arthroscopy for further evaluation and confirmation. This approach may enhance diagnostic accuracy while minimizing unnecessary invasive procedures.