Comparative evaluation of high-resolution ultrasonography and magnetic resonance imaging in painful wrist joint

Abstract

Introduction: Wrist joint is a commonly used joint in day-to-day activities and hence is not only susceptible to various pathologies but is also the cause of significant morbidity in cases of painful wrist. Although magnetic resonance imaging (MRI) is the usual imaging investigation preferred for the evaluation of painful wrist joint, its inherent limitations in form of high cost, limited availability, higher scan time, and lack of comparison with contralateral side have prompted us to design a study comparing the role of high-resolution ultrasonography (HRUS) with MRI in such cases. Materials and Methods: Forty patients of painful wrist joint were evaluated with HRUS and MRI following approval of IEC and after informed consent. The two imaging modalities were compared not only in the detection of various findings related to painful wrist joint as joint effusion, synovitis, synovial hypertrophy, tenosynovitis, rice bodies, bone erosions, etc., but also in diagnosing the final group of disease. Appropriate statistical tests were then used to analyze the results. Results: Our study revealed that HRUS is similar to MRI in the detection of joint effusion, synovitis, synovial hypertrophy, tenosynovitis, rice bodies, etc., but is very poor in the detection of bony pathologies, especially marrow edema or chronic fractures. In our study, HRUS was equivalent to MRI in the final diagnosis in 67.5% cases, was inferior to MRI in 30% cases and was superior to MRI in 2.5%. Conclusions: Since HRUS has a high accuracy in detecting the pathologies in cases of painful wrist joint, it should be used as the first imaging modality. Patients with equivocal diagnosis or requiring surgical planning may, however, be subjected to MRI.