Year: 2025 | Month: June | Volume: 12 | Issue: 6 | Pages: 642-649
DOI: https://doi.org/10.52403/ijrr.20250673
Comparative Evaluation of Ultrasound Versus Magnetic Resonance Imaging to Diagnosis of Triangular Fibro-Cartilaginous Complex: Systematic Review
Febyan1, James Rainagle1, Andri Nugraha2, Gery Perdana Yogaswara3
1Department of Orthopaedic & Traumatology, Faculty of Medicine, Udayana University, Prof IGNG Ngoerah General Hospital, Bali, Indonesia
2General Practitioner, Puskesmas Pasirkuda, Cianjur, West Java, Indonesia
3Department of Radiology, RSUD Cimacan, Cianjur, West Java, Indonesia
Corresponding Author: Febyan
ABSTRACT
Background: The triangular fibrocartilage complex (TFCC) is a key stabilizer of the distal radioulnar and ulnocarpal joints, and is commonly implicated in ulnar-sided wrist pain following trauma. While arthroscopy remains the diagnostic gold standard, non-invasive imaging modalities such as ultrasound and magnetic resonance imaging (MRI) are widely used for TFCC evaluation. This systematic review aims to compare the diagnostic accuracy of ultrasound and MRI in detecting TFCC injuries.
Methods: This review followed PRISMA guidelines. A comprehensive search was conducted across PubMed, Scopus, and Embase using MeSH terms and keywords related to TFCC, ultrasound, MRI, and diagnosis. Inclusion criteria encompassed studies comparing both imaging modalities with reported sensitivity, specificity, or diagnostic accuracy. Data were extracted on study design, imaging modalities, and outcomes. Risk of bias was assessed using the ROBINS-I tool.
Results: Four studies with sample sizes ranging from 30 to 72 patients were included. All studies evaluated ultrasound and MRI performance in detecting TFCC injuries; one also included MR arthrography (MRA). Ultrasound showed high diagnostic performance, with sensitivity up to 99.1% and specificity up to 97.3% in experienced hands. However, MRI demonstrated superior accuracy in detecting deep intra-articular lesions, and MRA was most effective in evaluating subtle or equivocal findings. Operator dependency was a major limitation of ultrasound. The ROBINS-I assessment indicated an overall low risk of bias across all studies.
Conclusion: Ultrasound is an accessible, cost-effective, and efficient first-line modality for TFCC evaluation, particularly in acute or resource-limited settings. Nonetheless, MRI remains the gold standard for comprehensive assessment, and MRA is recommended for complex or inconclusive cases. Standardized ultrasound training is essential to optimize diagnostic reliability.
Keywords: Ultrasound, MRI, diagnostic imaging, triangular fibrocartilage complex
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