Der ulnokarpale Komplex

Schmitt, Rainer; Grunz, Jan-Peter; Luetkens, Karsten Sebastian; Haas-Lützenberger, Elisabeth Maria; Hesse, Nina

doi:10.1007/s00117-021-00824-4

Cited by 5 publications

(2 citation statements)

References 44 publications

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“…Die avaskuläre Beschaffenheit des zentralen Diskus stellt eine Herausforderung für die intrinsische Heilung dar und beeinflusst dadurch die Behandlungsstrategie [24]. Demgegenüber sind sowohl die radioulnaren Steuerbänder als auch die TFCC-Peripherie (ulnokarpale Bänder, Meniscus homologue, ECU-Sehnen-Scheide und ulnares Kollateralband) kräftig vaskularisiert, was die Bildgebung und die therapeutischen Optionen beeinflusst [25].…”

Section: Läsionen Des Triangulären Fibrokartilaginären Komplexesunclassified

Der ulnarseitige Handgelenksschmerz

Grunz

2024

Radiologie up2date

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Section: Läsionen Des Triangulären Fibrokartilaginären Komplexesunclassified

Der ulnarseitige Handgelenksschmerz

Grunz

2024

Radiologie up2date

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“…Besides clinical findings, hand surgeons rely heavily on imaging to indicate either conservative or operative treatment with MRI being the method of choice for three-dimensional wrist evaluation. To achieve the contrast-to-noise ratio necessary for a depiction of microstructural alterations of cartilage and ligaments, different MRI techniques can be applied: while plain T2-weighted sequences depend on effusion surrounding the rupture site and T1-weighted MRI after intravenous gadolinium application requires reactive hyperemia of the adjacent synovial tissue for lesion visualization, MR arthrography is capable of directly displaying TFCC discontinuity [7][8][9]. However, even in MR examinations after direct arthrography, radiologic standard planes frequently fail to depict the entirety of the TFCC due to its complex triangular shape and small component size.…”

Section: Introductionmentioning

confidence: 99%

Improved diagnostic accuracy for ulnar-sided TFCC lesions with radial reformation of 3D sequences in wrist MR arthrography

et al. 2021

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Objectives Triangular fibrocartilage complex (TFCC) injuries frequently cause ulnar-sided wrist pain and can induce distal radioulnar joint instability. With its complex three-dimensional structure, diagnosis of TFCC lesions remains a challenging task even in MR arthrograms. The aim of this study was to assess the added diagnostic value of radial reformatting of isotropic 3D MRI datasets compared to standard planes after direct arthrography of the wrist. Methods Ninety-three patients underwent wrist MRI after fluoroscopy-guided multi-compartment arthrography. Two radiologists collectively analyzed two datasets of each MR arthrogram for TFCC injuries, with one set containing standard reconstructions of a 3D thin-slice sequence in axial, coronal and sagittal orientation, while the other set comprised an additional radial plane view with the rotating center positioned at the ulnar styloid. Surgical reports (whenever available) or radiological reports combined with clinical follow-up served as a standard of reference. In addition, diagnostic confidence and assessability of the central disc and ulnar-sided insertions were subjectively evaluated. Results Injuries of the articular disc, styloid and foveal ulnar attachment were present in 20 (23.7%), 10 (10.8%) and 9 (9.7%) patients. Additional radial planes increased diagnostic accuracy for lesions of the styloid (0.83 vs. 0.90; p = 0.016) and foveal (0.86 vs. 0.94; p = 0.039) insertion, whereas no improvement was identified for alterations of the central cartilage disc. Readers’ confidence (p < 0.001) and assessability of the ulnar-sided insertions (p < 0.001) were superior with ancillary radial reformatting. Conclusions Access to the radial plane view of isotropic 3D sequences in MR arthrography improves diagnostic accuracy and confidence for ulnar-sided TFCC lesions. Key Points • In multi-compartment arthrography of the wrist, ancillary radial plane view aids assessability of the foveal and styloid ulnar-sided insertions of the triangular fibrocartilage complex. • Assessment of peripheral TFCC injuries is more accurate with access to radial multiplanar reconstructions. • Additional radial planes provide greater diagnostic confidence.

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