Triangular fibrocartilage complex injury
Updates to Article Attributes
Body
was changed:
Triangular fibrocartilage complex (TFCC) injuries may be traumatic or degenerative in nature. The TFCC is a complex structure consisting of the triangular fibrocartilage disc proper, ulnomeniscal homologue and numerous ligaments and tendons.
Clinical presentation
Traumatic injuries are usually symptomatic whereas degeneration of the TFCC is usually asymptomatic 1.
Pathology
Assessing the triangular fibrocartilage for tears is important but isolated injuries to the ulnomeniscal homologue or radioulnar ligaments can lead to distal radioulnar joint instability. Associated injuries that should be assessed include 1:
- ulnar styloid avulsion fracture
- extensor carpi ulnaris tendinopathy (including tendinosis, tear and/or instability)
- ulnar collateral ligament injury
- ganglion cyst formation (may be soft tissue or intraosseous)
Classification
- Palmer classification help the accurate recognition and diagnosis of TFCC injuries, however, is not comprehensive and injuries outside this classification system can occur 2
Radiographic features
MRI
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triangular fibrocartilage tears 1
- fluid-intensity signal extending to the surface or along the medial aspect of the ulna
- usually associated with distal radioulnar joint (DRUJ) effusions (however, these are non-specific in isolation)
- ulnar styloid process or foveal cystic change or bone marrow oedema
- perifascial fluid and/or oedema
Practical points
- medial tears are in the vascularised zone and surgical repair is a treatment option whereas central tears are in the avascular zone and are typically debrided 1
-<p><strong>Triangular fibrocartilage complex (TFCC) injuries </strong>may be traumatic or degenerative in nature. The <a href="/articles/triangular-fibrocartilage-complex">TFCC</a> is a complex structure consisting of the triangular fibrocartilage proper, <a href="/articles/ulnomeniscal-homologue">ulnomeniscal homologue</a> and numerous ligaments and tendons.</p><h4>Clinical presentation</h4><p>Traumatic injuries are usually symptomatic whereas degeneration of the TFCC is usually asymptomatic <sup>1</sup>. </p><h4>Pathology</h4><p>Assessing the triangular fibrocartilage for tears is important but isolated injuries to the ulnomeniscal homologue or radioulnar ligaments can lead to distal radioulnar joint instability. Associated injuries that should be assessed include <sup>1</sup>:</p><ul>- +<p><strong>Triangular fibrocartilage complex (TFCC) injuries </strong>may be traumatic or degenerative in nature. The <a href="/articles/triangular-fibrocartilage-complex">TFCC</a> is a complex structure consisting of the <a title="triangular fibrocartilage disc proper" href="/articles/triangular-fibrocartilage-disc-proper">triangular fibrocartilage disc proper</a>, <a href="/articles/ulnomeniscal-homologue">ulnomeniscal homologue</a> and numerous ligaments and tendons.</p><h4>Clinical presentation</h4><p>Traumatic injuries are usually symptomatic whereas degeneration of the TFCC is usually asymptomatic <sup>1</sup>. </p><h4>Pathology</h4><p>Assessing the triangular fibrocartilage for tears is important but isolated injuries to the ulnomeniscal homologue or radioulnar ligaments can lead to distal radioulnar joint instability. Associated injuries that should be assessed include <sup>1</sup>:</p><ul>
-</ul><h4>Classification</h4><ul><li><a href="/articles/palmer-classification-of-tfcc-abnormalities">Palmer classification</a></li></ul><h4>Radiographic features</h4><h5>MRI</h5><ul><li>- +</ul><h4>Classification</h4><ul><li>
- +<a href="/articles/palmer-classification-of-tfcc-abnormalities">Palmer classification</a> help the accurate recognition and diagnosis of TFCC injuries, however, is not comprehensive and injuries outside this classification system can occur <sup>2</sup> </li></ul><h4>Radiographic features</h4><h5>MRI</h5><ul><li>
References changed:
- 2. Skalski MR, White EA, Patel DB, Schein AJ, RiveraMelo H, Matcuk GR. The Traumatized TFCC: An Illustrated Review of the Anatomy and Injury Patterns of the Triangular Fibrocartilage Complex. (2016) Current problems in diagnostic radiology. 45 (1): 39-50. <a href="https://doi.org/10.1067/j.cpradiol.2015.05.004">doi:10.1067/j.cpradiol.2015.05.004</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/26117527">Pubmed</a> <span class="ref_v4"></span>