In a retrospective survey we compared the magnetic resonance imaging (MRI) protocols with the arthroscopic findings for triangular fibrocartilage complex (TFCC) lesions. We found a sensitivity of 0.61 and specificity of 0.88 for MRI. The positive predictive value was 0.85 and the negative predictive value was only 0.68. These values are very similar to those in other recent surveys. These findings and the reviewed publications all indicate that MRI cannot replace arthroscopy. Special coils and MRI-arthrography can significantly enhance the specificity and the sensitivity. A negative MRI is not an endpoint and not a contraindication for further exploration, in particular for arthroscopy.