Article

Characteristics of triangular fibrocartilage defects in symptomatic and contralateral asymptomatic wrists. Radiology 216: 840-845

Department of Radiology, Orthopedic University Hospital Balgrist, University of Zurich, Switzerland.
Radiology (Impact Factor: 6.21). 10/2000; 216(3):840-5. DOI: 10.1148/radiology.216.3.r00se06840
Source: PubMed

ABSTRACT To characterize triangular fibrocartilage (TFC) defects in symptomatic and contralateral asymptomatic wrists.
Communicating and noncommunicating defects of the TFC were depicted on bilateral wrist arthrograms in 56 patients with unilateral wrist pain and without associated lesions of the scapholunate or lunotriquetral ligaments. The exact location of each TFC lesion was noted.
Communicating defects were noted in 36 (64%) of 56 symptomatic and in 26 (46%) of 56 asymptomatic wrists. Twenty-five (69%) of 36 communicating defects were bilateral. Except for one defect in each group of symptomatic and asymptomatic wrists, all communicating defects were noted radially. Noncommunicating defects were noted in 28 (50%) of 56 symptomatic wrists and in 15 (27%) of 56 asymptomatic wrists. Eleven (39%) of 28 noncommunicating defects were bilateral. On the symptomatic side, 28 of 36 noncommunicating defects (including eight multiple defects) were located proximally at the ulnar side. On the asymptomatic side, 11 of 17 noncommunicating defects (including two multiple defects) were at or near the ulna.
Noncommunicating TFC defects, which typically are located on the proximal side of the TFC near its ulnar attachment, have a more reliable association with symptomatic wrists than do communicating defects. Radial-sided communicating defects described in the literature (Palmer type 1A and 1D) as posttraumatic commonly are seen bilaterally and in asymptomatic wrists.

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    • "Noncommunicating TFCC defects, which typically are located on the proximal side of the TFC near its ulnar attachment, have a more reliable association with symptomatic wrists than do communicating defects [57]. Radial-sided communicating defects described in the literature as post-traumatic commonly are seen bilaterally and in asymptomatic wrists [57]. The TFCC with associated bony fracture is adequately analyzed using multidetector CT arthrography. "
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    • "In older patients a signal may be seen within the low-signal TFC on T1-weighted and proton-density – weighted MR images that is thought to be caused by mucoid and myxoid degenerative changes. Degeneration of the TFC is frequently seen and often asymptomatic [39] [40]. When there is degeneration of the TFC, MR imaging shows intermediate-signal intensity on short-echo-time images that does not increase on T2-or T2*-weighted images. "
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