Thursday, July 14, 2011

TRIANGULAR FIBROCARTILAGE COMPLEX- MRI


Teaching points about TFCC by Dr MGK Murthy & Mr Abdul Hamid





- Normally responsible for ulnar sided wrist pain.
- Thickness is inversely related to ulnar variance with negative ulnar variance patients  having thicker TFCC.
- Normally is 1 to 2 mm thick at most locations with subtle increased upto 5 mm in the vicinity of eccentric concavity of the ulnar styloid.
- Being of type-I collagen is usually dark on all sequences like  the knee ligaement.
- Coronal fat suppressed sequence is most appropriate for study of TFCC.
- The blood supply is usually well maintained at the periphery with relatively avascular centre which leads to central perforations not healing well.
- Dorsal and the palmar branches of the anterior introsseous artery along with dorsal and the palmar branches of ulnar artery supply TFCC. 
- Has attachments to lunate, triquetral, hamate and base of the 5th metacarpal.
- Closely approximated to extensor carpi ulnaris tendon and associated injuries are common.
- MDCT Arthrography of the wrist  is suggested to be superior in some studies, to MR Arthrography or Conventional Arthrography.
- Degeneration starts in 3rd decade with heterogenity being the rule by the 4th decade.

2 comments:

Brian said...

Hi,

Nice images and a great discussion.

I agree that CT arthrography is a great modality for the evaluation of the TFCC.

Keep up the nice work on these very educational cases.

Brian Sabb
www.linkedin.com/in/briansabb

Sumer Sethi said...

thanks Brian for the kind comments.

Blog Archive