European RadiologyEuropean Radiologyhttp5/doi.org/10.1007/s00330-023-09698-7ROF RADIOLOGYMUSCULOSKELETALInterdisciplinary consensus statements on imaging of DRUJ instabilityand TFCC injuriesLuis Cerezal.Francisco del Pinal2.Andrea Atzei34.Rainer Schmitt5,6.Fabio Becce78.Maciej Klich.Maciej Bien10.Milko C.de Jonge11.James Teh12.Robert Downey Boutin13.Andoni Paul Toms14.Patrick Omoumi15.Jan Fritz16.Alberto Bazzocchi17.Maryam Shahabpour18.Marco Zanetti19.Eva Llopis20Alain Blum21.Radhesh Krishna Lalam22.Sutter Reto23,24.P.Diana Afonso25,26.Vasco V.Mascarenhas25,27.Anne Cotten2829.Jean-Luc Drape3.Guillaume Bierry31.Grzegorz Pracon1.Danoob Dalili32.Marc Mespreuve33.Marc Garcia-Elias.Gregory lan Bain35.Christophe L.Mathoulin36.Luc Van Overstraeten3738.Robert M.Szabo3Emmanuel J.Camus4041.Riccardo Luchetti42.Adrian Julian Chojnowski43.Joerg G.Gruenert44.Piotr Czarnecki45Fernando Corella464748.Ladislav Nagy49.Michiro Yamamoto50.Igor O.Golubev51.Jorg van Schoonhoven52.Florian Goehtz52.Iwona Sudol-Szopinska53.Tobias Johannes Dietrich54.24Received:15 January 2023/Revised:9 March 2023/Accepted:5 April 2023The Author(s),under exclusive licence to European Society of Radiology 2023AbstractObjectives The purpose of this agreement was to establish evidence-based consensus statements on imaging of distal radi-oulnar joint(DRUJ)instability and triangular fibrocartilage complex (TFCC)injuries by an expert group using the Delphitechnique.Methods Nineteen hand surgeons developed a preliminary list of questions on DRUJ instability and TFCC injuries.Radiolo-gists created statements based on the literature and the authors'clinical experience.Questions and statements were revisedduring three iterative Delphi rounds.Delphi panelists consisted of twenty-seven musculoskeletal radiologists.The panelistsscored their degree of agreement to each statement on an 11-item numeric scale.Scores of“o,”“5,”and“l0”reflectedcomplete disagreement,indeterminate agreement,and complete agreement,respectively.Group consensus was defined asa 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 groupconsensus in the second Delphi round.The third and final Delphi round was limited to the one question that did not achievegroup consensus in the previous rounds.Conclusions Delphi-based agreements suggest that CT with static axial slices in neutral rotation,pronation,and supination is themost useful and accurate imaging technique for the work-up of DRUJ instability.MRI is the most valuable technique in the diag-nosis 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 thanperipheral abnormalities.The main indication for MR arthrography is the evaluation of TFCC foveal insertion lesions andperipheral non-Pal
