High-resolution 3-T MRI of the triangular fibrocartilage complex in the wrist: injury pattern and MR features

Zhan, Huili; Zhang, Huibo; Renju, Bai; Qian, Zhihui; Liu, Yue; Zhang, Heng; Yin, Yuming

doi:10.1007/s00256-017-2739-x

Cited by 15 publications

(18 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…With the recent development of MRI techniques, additional TFCC abnormalities can be visualized [24]. Discontinuation between the dorsal and volar edges of the TFC with the joint capsule is currently suggested as a pathological capsular detachment and as an additional type of Palmer injury [24]. In the present study, a discontinuation of the volar RUL with the TFC due to a linear hyper-intense signal intensity was found in 23 (25%) observations mimicking this capsular detachment.…”

Section: Discussionsupporting

confidence: 50%

“…Since the young participants did not perform wrist-loading sports more than twice a week, this highly unlikely represents degeneration. Also, a vertical linear increased signal intensity of the TFC with discontinuation of the disc, currently interpreted as a traumatic TFC perforation (Palmer 1A injury), was seen in 20% of observations [24].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…A standardized scoring form focusing on observation of morphology, homogeneity, and signal intensity and explicitly not on detecting pathology was constructed by a physician experienced in research on musculoskeletal imaging (AP). Due to the lack of a consensus reference standard regarding the individual TFCC components, the items were based on MRI definitions used by Zhan et al on adults, i.e., triangular fibrocartilage (TFC), dorsal and volar radioulnar ligaments (RUL), meniscus homolog, extensor carpi ulnaris (ECU) tendon sheath, ulnocarpal ligaments (ulnolunate and ulnotriquetral), and ulnar collateral ligament [24]. Images from trial cases that were not included in the present study (i.e., symptomatic gymnasts) were provided as illustrative examples in the scoring form (see supplementary material).…”

Section: Standardized Scoring Formmentioning

confidence: 99%

See 3 more Smart Citations

The triangular fibrocartilage complex on high-resolution 3 T MRI in healthy adolescents: the thin line between asymptomatic findings and pathology

et al. 2021

View full text Add to dashboard Cite

Objective The objective of the study is to provide a reference for morphology, homogeneity, and signal intensity of triangular fibrocartilage complex (TFCC) and TFCC-related MRI features in adolescents. Materials and methods Prospectively collected data on asymptomatic participants aged 12–18 years, between June 2015 and November 2017, were retrospectively analyzed. A radiograph was performed in all participants to determine skeletal age and ulnar variance. A 3-T MRI followed to assess TFCC components and TFCC-related features. A standardized scoring form, based on MRI definitions used in literature on adults, was used for individual assessment of all participants by four observers. Results per item were expressed as frequencies (percentages) of observations by all observers for all participants combined (n = 92). Inter-observer agreement was determined by the unweighted Fleiss’ kappa with 95% confidence intervals (95% CI). Results The cohort consisted of 23 asymptomatic adolescents (12 girls and 11 boys). Median age was 13.5 years (range 12.0–17.0). Median ulnar variance was −0.7 mm (range − 2.7–1.4). Median triangular fibrocartilage (TFC) thickness was 1.4 mm (range 0.1–2.9). Diffuse increased TFC signal intensity not reaching the articular surface was observed in 30 (33%) observations and a vertical linear increased signal intensity with TFC discontinuation in 19 (20%) observations. Discontinuation between the volar radioulnar ligament and the TFC in the sagittal plane was seen in 23 (25%) observations. The extensor carpi ulnaris was completely dislocated in 10 (11%) observations, more frequent in supinated wrists (p = 0.031). Inter-observer agreement ranged from poor to fair for scoring items on the individual TFCC components. Conclusion MRI findings, whether normal variation or asymptomatic abnormality, can be observed in TFCC and TFCC-related features of asymptomatic adolescents. The rather low inter-observer agreement underscores the challenges in interpreting these small structures on MRI. This should be taken into consideration when interpreting clinical MRIs and deciding upon arthroscopy.

show abstract

Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Standardized Scoring Formmentioning

confidence: 99%

See 2 more Smart Citations

The triangular fibrocartilage complex on high-resolution 3 T MRI in healthy adolescents: the thin line between asymptomatic findings and pathology

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Class 2 injuries indicate degeneration of the TFCC with or without precedent trauma [1]. The severity is incremental from Class 2A to 2E [36]. Class 2A injuries indicate wear of the articular disc.…”

Section: Pathologies—classificationmentioning

confidence: 99%

Ulnar Wrist Pain Revisited: Ultrasound Diagnosis and Guided Injection for Triangular Fibrocartilage Complex Injuries

Chang

Mezian

et al. 2019

JCM

View full text Add to dashboard Cite

The triangular fibrocartilage complex (TFCC) serves as the major stabilizer of the wrist. Its injuries can result from trauma or degeneration, both of which are strongly correlated with the loading stress on the ulnar shaft and carpal joints. The TFCC is made of the articular disc, meniscus homologue, ulnocarpal ligament, radioulnar ligament, ulnotriquetral ligament, ulnolunate ligament, and subsheath of the extensor carpi ulnaris tendon. Because of its complexity, it is challenging to confirm the exact component affected in TFCC injuries. The Palmer classification is widely used for investigation of TFCC lesions using magnetic resonance imaging. Recently, high-resolution ultrasound (US) has become more popular in diagnosing musculoskeletal disorders. However, the utility of US imaging in TFCC lesions is less common because its anatomy under US imaging is not described in the current literature. Accordingly, in this review, we aimed to propose a standard US scanning protocol for the TFCC, present relevant images for its pathologies, and illustrate appropriate US-guided injection techniques for their management.

show abstract

The triangular fibrocartilage complex in the human wrist: A scoping review toward uniform and clinically relevant terminology

et al. 2022

View full text Add to dashboard Cite

show abstract

High-resolution 3-T MRI of the triangular fibrocartilage complex in the wrist: injury pattern and MR features

Cited by 15 publications

References 25 publications

The triangular fibrocartilage complex on high-resolution 3 T MRI in healthy adolescents: the thin line between asymptomatic findings and pathology

The triangular fibrocartilage complex on high-resolution 3 T MRI in healthy adolescents: the thin line between asymptomatic findings and pathology

Ulnar Wrist Pain Revisited: Ultrasound Diagnosis and Guided Injection for Triangular Fibrocartilage Complex Injuries

The triangular fibrocartilage complex in the human wrist: A scoping review toward uniform and clinically relevant terminology

Contact Info

Product

Resources

About