Triangular Fibrocartilage: Magnified MRI
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A magnified, coronal, water
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weighted MRI view of the TFC.
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Let's start off simple.
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On the radial side, we've got some higher signal
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intensity hyaline cartilage, and the attachment to it
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looks a little bit like a goblet lying on its side.
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Remember that avulsions, or separations, here are rare.
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Most tears are going to be here or here, in
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the middle or central one-third of the TFC.
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Volume averaged, we have hyaline cartilage,
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and capsulocynovial tissue, which we can't really see.
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And the same thing on the ulnar side, or proximal
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margin, of the triangular fibrocartilage.
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Then within our yellow circle, we've
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got some peripheral attachments.
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And these include some distal ones to the, to
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the styloid, which we can see are somewhat wispy.
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These form the superficial layer of the
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peripheral attachment, part of which
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is composed of the volar and dorsal.
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The deeper layer, which I'll pick another color
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for, is formed by a group of folds that come
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off the tip of the triangular fibrocartilage.
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So here's the tip.
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These folds are often a little bit kinked, and you
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can see they are a little bit kinked and irregular.
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They're highlighted by a little bit of inflammation.
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And these tiny little wispy areas that we
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see here, I'll color over them right now and
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say yellow, right there, these are vessels.
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Those vessels mix together with these other
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kinked or folded structures to insert onto
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the fovea near the forearm axis of rotation.
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This is the deep layer of the peripheral attachment
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of the TFC known as the ligamentum subcruentum.
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The rest of the anatomy consists of filler,
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including, and I'll draw over it, we'll call
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it gray since it's kind of uninteresting,
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the ulnomeniscus homologue, surrounded by some
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slightly brighter tissue. We'll make it darker gray.
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The joint capsule, and they're kind of mixed
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together to kind of fill in this, this space.
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We also visualize the lunotriquetral ligament.
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Well, we'll make that green, there it is.
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And the lunato triquetral ligament has an
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attachment back to the TFC, which is this
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darker tissue that I've just colored over.
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The ulnar carpal ligament, of which
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there is a palmar and a dorsal one.
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How's that for magnified MRI?
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
ProScan Imaging
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