Diagnostic value of MRI in traumatic triangular fibrocartilage complex injuries: a retrospective study

Review written by Dr Ian Gatt info

Key Points

  1. MRI is an effective tool in detecting Triangular fibrocartilage complex (TFCC) injuries but does not precisely determine the location of peripheral tears, particularly in proximal component TFCC tears.
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BACKGROUND & OBJECTIVE

Triangular fibrocartilage complex (TFCC) injuries commonly manifest as ulnar-sided wrist pain and can be associated with distal radioulnar joint (DRUJ) instability and subsequent wrist functional decline. TFCC functions as the primary stabilizer of the ulnar aspect of the wrist (1). Traumatic TFCC injuries commonly occur following a fall on the upper limb or a rotational forearm injury.

The ulnar fovea sign and ulnar grinding test can assist in diagnosing TFCC injuries, however, with varied specificity and sensitivity (2-4). MRI scan is commonly utilized for evaluating TFCC injuries due to its non-invasiveness, accessibility, and spatial resolution (5,6), however these scans don’t allow for the size and location of these injuries to be precisely assessed (7). Wrist arthroscopy is considered the gold standard for identifying TFCC injuries for diagnosis and repair of the injured TFCC (8-10). However, wrist arthroscopy is an invasive procedure, as compared to both clinical and radiological tests.

The purpose of this study was to evaluate the value of MRI in the qualitative diagnosis and localization of traumatic (Palmer type 1) TFCC injuries compared with arthroscopy in a normal clinical setting, determining the distribution of different subtypes of TFCC injuries.

The Triangular fibrocartilage complex functions as the primary stabilizer of the ulnar aspect of the wrist.
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MRI is an effective tool in detecting TFCC injuries but may not precisely determine the location of peripheral tears, particularly in proximal component TFCC tears.

METHODS

  • This retrospective study considered a total of 214 consecutive patients from 2020 to 2022.
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