High-resolution 3T Magnetic Resonance Imaging of the Triangular Fibrocartilage Complex in Chinese Wrists

Zhan, Huili; Li, Wenting; Renju, Bai; Wang, Nai‐Li; Qian, Zhihui; Wei, Ye; Yin, Yuming

doi:10.4103/0366-6999.202746

Cited by 5 publications

(48 citation statements)

References 35 publications

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“…MRI, with its excellent soft-tissue resolution and multiplanar imaging capabilities, has become a preferred modality in evaluation of ligamentous and tendinous injuries in the hands and fingers. [ 18 19 20 21 22 23 24 ]…”

Section: Discussionmentioning

confidence: 99%

Sports Injury-Related Fingers and Thumb Deformity Due to Tendon or Ligament Rupture

Renju

Huibo

Zhan

et al. 2018

Chinese Medical Journal

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Background:Hand injuries are very common in sports, such as skiing and ball sports. One of the major reasons causing hand and finger deformity is due to ligament and tendon injury. The aim of this study was to investigate if the high-resolution 3T magnetic resonance imaging (MRI) can demonstrate the complex anatomy of the fingers and thumb, especially the tendons and ligaments, and provide the accurate diagnosis of clinically important fingers and thumbs deformity due to ligamentous and tendinous injuries during sport activities.Methods:Sixteen fresh un-embalmed cadaveric hands were harvested from eight cadavers. A total of 20 healthy volunteers' hands and 44 patients with fingers or thumb deformity due to sports-related injuries were included in this study. All subjects had MR examination with T1-weighted images and proton density-weighted imaging with fat suppression (PD FS) in axial, coronal, and sagittal plane, respectively. Subsequently, all 16 cadaveric hands were sliced into 2-mm thick slab with a band saw (six in coronal plane, six in sagittal plane, and four in axial plane). The correlation of anatomic sections and the MRI characteristics of tendons of fingers and the ulnar collateral ligament (UCL) at the metacarpal phalangeal joint (MCPJ) of thumb between 20 healthy volunteers and 44 patients (confirmed by surgery) were analyzed.Results:The normal ligaments and tendons in 16 cadaveric hands and 20 volunteers' hands showed uniform low-signal intensity on all the sequences of the MRI. Among 44 patients with tendinous and ligamentous injuries in the fingers or thumb, 12 cases with UCL injury at MCPJ of the thumb (Stener lesion = 8 and non-Stener lesion = 4), 6 cases with the central slip injury, 12 cases with terminal tendon injury, and 14 cases with flexor digitorum profundus injury. The ligaments and tendons disruption manifested as increased signal intensity and poor definition, discontinuity, and heterogeneous signal intensity of the involved ligaments and tendons.Conclusions:Sports injury-related fingers and thumb deformity are relatively common. MRI is an accurate method for evaluation of the anatomy and pathologic conditions of the fingers and thumb. It is a useful tool for accurate diagnosis of the sports-related ligaments and tendons injuries in hand.

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Section: Discussionmentioning

confidence: 99%

Sports Injury-Related Fingers and Thumb Deformity Due to Tendon or Ligament Rupture

Renju

Huibo

Zhan

et al. 2018

Chinese Medical Journal

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“…In eight out of the 24 studies, a definition of the TFCC was provided by explicitly stating all its individual components, as far as recognized by the authors (see Table 2). All of these eight studies consistently included (1) the articular disc (proper), (2) the dorsal and volar radioulnar ligaments (also referred to as proximal triangular ligament), (3) the meniscus homologue (also referred to as ulnocarpal meniscoid) and (4) the extensor carpi ulnaris tendon (sub)sheath (also referred to as the dense part of the ulnar collateral ligament) (Ishii et al, 1998; Nakamura et al, 1996; Nakamura & Yabe, 2000; Rein et al, 2015; Semisch et al, 2016; Shigemitsu et al, 2007; Totterman & Miller, 1995; Zhan, Li, et al, 2017).…”

Section: Resultsmentioning

confidence: 99%

“…Seven out of eight studies also included the ulnolunate and the ulnotriquetral ligaments in their definition (Ishii et al, 1998; Nakamura et al, 1996; Nakamura & Yabe, 2000; Rein et al, 2015; Semisch et al, 2016; Totterman & Miller, 1995; Zhan, Li, et al, 2017). One out of eight studies included the internal portion (identical to the ligamentum subcruentum) of the TFCC as a separate component (Shigemitsu et al, 2007).…”

Section: Resultsmentioning

confidence: 99%

“…The most prominent disagreement on TFCC components between studies existed for the ulnar collateral ligament. Three out of eight studies claimed that the structure, or at least its loose part, was a TFCC component (Nakamura et al, 1996; Shigemitsu et al, 2007; Zhan, Li, et al, 2017). In five out of eight studies, authors stated that the ulnar collateral ligament was not a component or defined it as only a thickened ulnar capsule (Ishii et al, 1998; Nakamura & Yabe, 2000; Rein et al, 2015; Semisch et al, 2016; Totterman & Miller, 1995).…”

Section: Resultsmentioning

confidence: 99%

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The triangular fibrocartilage complex in the human wrist: A scoping review toward uniform and clinically relevant terminology

et al. 2022

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“…These ligaments have superficial and deep limbs, which are attached to the ulnar styloid process and its fovea, respectively (Figure 1C) [12,13]. The two limbs are separated by fibro-vascular tissues, i.e., ligamentum subcruentum [14]. The ulnar fovea is a bony depression between the hyaline cartilage of the distal ulna and the ulnar styloid [15].…”

Section: Anatomymentioning

confidence: 99%

Ulnar Wrist Pain Revisited: Ultrasound Diagnosis and Guided Injection for Triangular Fibrocartilage Complex Injuries

Chang

Mezian

et al. 2019

JCM

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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.

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High-resolution 3T Magnetic Resonance Imaging of the Triangular Fibrocartilage Complex in Chinese Wrists

Cited by 5 publications

References 35 publications

Sports Injury-Related Fingers and Thumb Deformity Due to Tendon or Ligament Rupture

Sports Injury-Related Fingers and Thumb Deformity Due to Tendon or Ligament Rupture

The triangular fibrocartilage complex in the human wrist: A scoping review toward uniform and clinically relevant terminology

Ulnar Wrist Pain Revisited: Ultrasound Diagnosis and Guided Injection for Triangular Fibrocartilage Complex Injuries

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