Tears of the triangular fibrocartilage of the wrist: MR imaging.

Abstract

Magnetic resonance (MR) imaging of the wrist was performed in 35 patients with specific complaints of pain and soft-tissue swelling in the medial side of the wrist. Twenty of the 35 subsequently underwent surgery. In 14 of the patients who underwent surgery, a diagnosis of triangular fibrocartilage (TFC) tear was made at MR imaging; in 13 of the 14 the tear was confirmed by surgical findings. In the six patients with an MR diagnosis of an intact TFC, surgical findings confirmed the diagnosis. These patients were operated on for an abnormality in the vicinity of the TFC (avascular necrosis, ganglion cyst, xanthoma). On the basis of findings from the 20 patients with surgical correlation, the accuracy of MR imaging in the detection of TFC tears was 95%. MR imaging is a valuable noninvasive method in the study of pathologic conditions of the TFC.

MR imaging of the traumatic triangular fibrocartilaginous complex tear

“…These include the triangular fibrocartilagous articular disc, volar and dorsal radioulnar ligaments, volar ulnotriquetral and ulnolunate ligaments, ulnar collateral ligament, extensor carpi ulnaris (ECU) tendon sheath and ulnomeniscal homologue (3,(7)(8)(9).…”

Osteoarthritis of the Wrist

“…(Pirela-Cruz, Goll et al 1991). An MRI is more useful if there is clinical suspicion of a triangular fibrocartilage tear or other cartilage defects (Golimbu, Firooznia et al 1989). A bone scan is warranted in patients with a high clinical suspicion of DRUJ pathology who have a negative plain radiograph (Shewring, Savage et al 1994).…”

Ulnar styloid impingement syndrome

“…MRI of the involved wrist was initially performed in all patients to rule out any TFCC tear, which could be attributed to the impingement by an excessively long ulnar styloid [16,17].…”