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Interdisciplinary consensus statements on imaging of DRUJ instability and TFCC injuries.

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Title: Interdisciplinary consensus statements on imaging of DRUJ instability and TFCC injuries.
Authors: Cerezal, Luis1 (AUTHOR) lcerezal@gmail.com, del Piñal, Francisco2 (AUTHOR), Atzei, Andrea3,4 (AUTHOR), Schmitt, Rainer5,6 (AUTHOR), Becce, Fabio7,8 (AUTHOR), Klich, Maciej9 (AUTHOR), Bień, Maciej10 (AUTHOR), de Jonge, Milko C.11 (AUTHOR), Teh, James12 (AUTHOR), Boutin, Robert Downey13 (AUTHOR), Toms, Andoni Paul14 (AUTHOR), Omoumi, Patrick15 (AUTHOR), Fritz, Jan16 (AUTHOR), Bazzocchi, Alberto17 (AUTHOR), Shahabpour, Maryam18 (AUTHOR), Zanetti, Marco19 (AUTHOR), Llopis, Eva20 (AUTHOR), Blum, Alain21 (AUTHOR), Lalam, Radhesh Krishna22 (AUTHOR), Reto, Sutter23,24 (AUTHOR)
Source: European Radiology. Sep2023, Vol. 33 Issue 9, p6322-6338. 17p. 1 Color Photograph, 3 Black and White Photographs, 2 Diagrams, 5 Charts.
Subjects: Joints (Anatomy), Delphi method, Wounds & injuries, Supination, Pronation
Abstract: Objectives: The purpose of this agreement was to establish evidence-based consensus statements on imaging of distal radioulnar joint (DRUJ) instability and triangular fibrocartilage complex (TFCC) injuries by an expert group using the Delphi technique. Methods: Nineteen hand surgeons developed a preliminary list of questions on DRUJ instability and TFCC injuries. Radiologists created statements based on the literature and the authors' clinical experience. Questions and statements were revised during three iterative Delphi rounds. Delphi panelists consisted of twenty-seven musculoskeletal radiologists. The panelists scored their degree of agreement to each statement on an 11-item numeric scale. Scores of "0," "5," and "10" reflected complete disagreement, indeterminate agreement, and complete agreement, respectively. Group consensus was defined as a score of "8" or higher for 80% or more of the panelists. Results: Three of fourteen statements achieved group consensus in the first Delphi round and ten statements achieved group consensus in the second Delphi round. The third and final Delphi round was limited to the one question that did not achieve group consensus in the previous rounds. Conclusions: Delphi-based agreements suggest that CT with static axial slices in neutral rotation, pronation, and supination is the most useful and accurate imaging technique for the work-up of DRUJ instability. MRI is the most valuable technique in the diagnosis of TFCC lesions. The main indication for MR arthrography and CT arthrography are Palmer 1B foveal lesions of the TFCC. Clinical relevance statement: MRI is the method of choice for assessing TFCC lesions, with higher accuracy for central than peripheral abnormalities. The main indication for MR arthrography is the evaluation of TFCC foveal insertion lesions and peripheral non-Palmer injuries. Key points: • Conventional radiography should be the initial imaging technique in the assessment of DRUJ instability. CT with static axial slices in neutral rotation, pronation, and supination is the most accurate method for evaluating DRUJ instability. • MRI is the most useful technique in diagnosing soft-tissue injuries causing DRUJ instability, especially TFCC lesions. • The main indications for MR arthrography and CT arthrography are foveal lesions of the TFCC. [ABSTRACT FROM AUTHOR]
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Interdisciplinary consensus statements on imaging of DRUJ instability and TFCC injuries.
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  Data: <searchLink fieldCode="AR" term="%22Cerezal%2C+Luis%22">Cerezal, Luis</searchLink><relatesTo>1</relatesTo> (AUTHOR)<i> lcerezal@gmail.com</i><br /><searchLink fieldCode="AR" term="%22del+Piñal%2C+Francisco%22">del Piñal, Francisco</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Atzei%2C+Andrea%22">Atzei, Andrea</searchLink><relatesTo>3,4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Schmitt%2C+Rainer%22">Schmitt, Rainer</searchLink><relatesTo>5,6</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Becce%2C+Fabio%22">Becce, Fabio</searchLink><relatesTo>7,8</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Klich%2C+Maciej%22">Klich, Maciej</searchLink><relatesTo>9</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bień%2C+Maciej%22">Bień, Maciej</searchLink><relatesTo>10</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22de+Jonge%2C+Milko+C%2E%22">de Jonge, Milko C.</searchLink><relatesTo>11</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Teh%2C+James%22">Teh, James</searchLink><relatesTo>12</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Boutin%2C+Robert+Downey%22">Boutin, Robert Downey</searchLink><relatesTo>13</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Toms%2C+Andoni+Paul%22">Toms, Andoni Paul</searchLink><relatesTo>14</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Omoumi%2C+Patrick%22">Omoumi, Patrick</searchLink><relatesTo>15</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Fritz%2C+Jan%22">Fritz, Jan</searchLink><relatesTo>16</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bazzocchi%2C+Alberto%22">Bazzocchi, Alberto</searchLink><relatesTo>17</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Shahabpour%2C+Maryam%22">Shahabpour, Maryam</searchLink><relatesTo>18</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Zanetti%2C+Marco%22">Zanetti, Marco</searchLink><relatesTo>19</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Llopis%2C+Eva%22">Llopis, Eva</searchLink><relatesTo>20</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Blum%2C+Alain%22">Blum, Alain</searchLink><relatesTo>21</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lalam%2C+Radhesh+Krishna%22">Lalam, Radhesh Krishna</searchLink><relatesTo>22</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Reto%2C+Sutter%22">Reto, Sutter</searchLink><relatesTo>23,24</relatesTo> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. Sep2023, Vol. 33 Issue 9, p6322-6338. 17p. 1 Color Photograph, 3 Black and White Photographs, 2 Diagrams, 5 Charts.
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– Name: Abstract
  Label: Abstract
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  Data: Objectives: The purpose of this agreement was to establish evidence-based consensus statements on imaging of distal radioulnar joint (DRUJ) instability and triangular fibrocartilage complex (TFCC) injuries by an expert group using the Delphi technique. Methods: Nineteen hand surgeons developed a preliminary list of questions on DRUJ instability and TFCC injuries. Radiologists created statements based on the literature and the authors' clinical experience. Questions and statements were revised during three iterative Delphi rounds. Delphi panelists consisted of twenty-seven musculoskeletal radiologists. The panelists scored their degree of agreement to each statement on an 11-item numeric scale. Scores of "0," "5," and "10" reflected complete disagreement, indeterminate agreement, and complete agreement, respectively. Group consensus was defined as a score of "8" or higher for 80% or more of the panelists. Results: Three of fourteen statements achieved group consensus in the first Delphi round and ten statements achieved group consensus in the second Delphi round. The third and final Delphi round was limited to the one question that did not achieve group consensus in the previous rounds. Conclusions: Delphi-based agreements suggest that CT with static axial slices in neutral rotation, pronation, and supination is the most useful and accurate imaging technique for the work-up of DRUJ instability. MRI is the most valuable technique in the diagnosis of TFCC lesions. The main indication for MR arthrography and CT arthrography are Palmer 1B foveal lesions of the TFCC. Clinical relevance statement: MRI is the method of choice for assessing TFCC lesions, with higher accuracy for central than peripheral abnormalities. The main indication for MR arthrography is the evaluation of TFCC foveal insertion lesions and peripheral non-Palmer injuries. Key points: • Conventional radiography should be the initial imaging technique in the assessment of DRUJ instability. CT with static axial slices in neutral rotation, pronation, and supination is the most accurate method for evaluating DRUJ instability. • MRI is the most useful technique in diagnosing soft-tissue injuries causing DRUJ instability, especially TFCC lesions. • The main indications for MR arthrography and CT arthrography are foveal lesions of the TFCC. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1007/s00330-023-09698-7
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