TFCC tear. How accurate is the MRI?

Question

I hurt my wrist back in Feb. I was restraining a 115 pound dog at work when it went crazy and I ended up bearing the entire weight of it on my right wrist. It didn't hurt too bad at first but by the end of the day my wrist was killing me and I figured it would be better by morning. Instead it was way worse. I bought a splint at Walgreens and wore that for a week and then finally went to a dr. Well after many misdiagnoses I finally had an MRI. The doctor put me in rehab for like 3 months with no improvement. My original complaint was clicking and grinding when I rotated my wrist. It went away for awhile with the physical theapy, but then came back. I then got a cortizone injection from my new orthopedic dr and that has gotten better. But all along I have had what I call straining pain on both sides of my wrist with any type of weight bearing. This has been going on for almost 7 months now. I stopped seeing my old orthopedic because his answer was more and more physical therapy. In fact my original p.t. wouldn't even treat me anymore because she couldn't get any improvement. So he wanted to send me to a hand therapist. That's when I went to the dr that gave me the cortisone injection. He suspects a TFCC tear. He didn't have any copies of my old medical records and wanted to know if I had an MRI with a wrist coil (I have no idea), I'm looking at the MRI report now and it says it was "performed utilizing mulitiple axial, saglttal, and coronal images in the T1, T2, and inversion recovery pulse sequences with and without fat suppression" Any ideas?

Well anyways, it says that the TCFF complex is intact. How accurate is the MRI? From everything I've read online, it seems that a tear of the TCFF thing describes everything that is wrong with me. The only reason I have doubts is that a few years ago I tore my ACL and the MRI report said that I didn't only to find out in surgery that my ACL was torn so badly 7 months prior that it no longer existed!!!

Answer 1

MRI is very sensitive but it is only as good as the person reading it. You are making the right decision to see a orthopedic surgeon who specializes in the hand. The is a good idea to make sure your specialist is fellowship trained and board certified. It is also good to see someone who is a member of the hand society (www.assh.org) and the AAOS (www.aaos.org). There are only a handful of top hand specialists I would see.

Answer 2

Craig makes an important point...MRI is subject to the reader. It's good you are going to bring your films to your specialist.

As a physical therapist AND someone who had a TFCC tear, I can tell you that my MRI was unreadable.  It's such a small joint that is sensitive to motion...therefore, greater room for error.  A CT with contrast might also be an option.  I went through about 6 months of conservative care and finally had the scope which confirmed a TFCC tear...I also had a leno-triquetrial tear of the carpal ligaments. I eventually went through a second procedure to shorten the ulna and tighten the remaining ligaments.  It's now better than my dominant hand.  

I also had great difficulty bearing weight through my hand and with things that required me to grasp and turn or grasp and lift.  

Good luck

Answer 3

the mri is normally one of the most accurate diagnostic imaging tools we have.however,it is not perfect.you need to be referred to an upper extremity orthopaedic surgeon,whose primary interest is in hand and wrist.an example,is a scaphoid fracture-these may not show up for several weeks after injury.a ct scan is sometimes the only way to diagnose. you may also consult a plastic surgeon who specializes in hands,wrists,and fingers..good luck!! you are an exceptionally well informed and involved patient.all people should be as involved and questioning in their care!!!!

Answer 4

i didnt read ur question but i hope u get better i tore my acl during a football game and i can neva play again