Abstract
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.
Highlights
Triangular fibrocartilage complex (TFCC) injuries are the most common cause of ulnar wrist pain
It is formed by the articular disc, meniscus homologue, ulnocarpal ligament, dorsal and palmar radioulnar ligaments, ulnar collateral ligament, ulnotriquetral ligament, ulnolunate ligament, subsheath of the extensor carpi ulnaris (ECU) tendon [2], and prestyloid recess, making it a complex structure for evaluation [3]
Inentht.is sense, this review aimed to propose a standard US scanning protocol for the TFCC, present exemplary images for its
Summary
Triangular fibrocartilage complex (TFCC) injuries are the most common cause of ulnar wrist pain. The TFCC serves as a major stabilizer of the distal radioulnar and ulnocarpal joints and provides cushion for the axial load of the forearm on the ulnocarpal joint [1] It is formed by the articular disc, meniscus homologue, ulnocarpal ligament, dorsal and palmar radioulnar ligaments, ulnar collateral ligament, ulnotriquetral ligament, ulnolunate ligament, subsheath of the extensor carpi ulnaris (ECU) tendon [2], and prestyloid recess, making it a complex structure for evaluation [3]. At the palmar aspect of the wrist, the TFCC is reinforced by the ulnolunate and ulnotriquetral ligaments, both of which originate from the palmar radioulnar ligament [1,17]
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