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Axial Anatomy: Intrinsic Ligaments

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Wrist, short axis view, intrinsic ligaments.

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You saw those in detail in the coronal projection,

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but they're not to be ignored in this projection.

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Let's begin with the scapholunate interval and ligament.

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6 00:00:19,149 --> 00:00:20,799 The first thing I do is not look at the

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ligament, I look at what's in between.

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In other words, what's the status of the

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bone and cartilage? Are they clean, pure,

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non-eroded, non-inflamed, no capsular

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thickening, no effusion, no synovitis?

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For if all those things are true, the odds of the

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ligament being deficient or torn are very low.

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So I use indirect signs.

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But I do see the ligament.

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The ligament consists of a dorsal

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component, which is the thickest.

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A membranous component, which is the

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thinnest and sometimes perforated.

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Fenestrated or asymptomatically torn, and

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then the volar or palmar component, which

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is smaller than the dorsal component.

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Not to be confused with this structure

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right here, which is an extrinsic.

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I also look at this distance to make sure

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that it's consistent from palmar to dorsal.

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Then I go over to the more difficult

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to see lunotriquetral ligament.

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It has a dorsal and a palmar component.

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Let's scroll.

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There's a dorsal component.

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Palmar component, a little tough to see.

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Let's scroll a little more distally.

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There's the dorsal component.

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There's the palmar component.

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There's some controversy about which one is

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stronger and which one is a greater stabilizer.

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However, many people believe that the dorsal

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portion of the ligament, regardless of

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its size, is the more important stabilizer.

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Don't confuse the dorsal or palmar

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intrinsic with the adjacent extrinsics.

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I do the same thing here.

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I look at the interval for smoothness,

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consistency, lack of erosions, lack of

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synovitis, lack of effusion, lack of capsulitis.

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I'm good.

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The intrinsic ligaments in the short axis are ejection.

Report

Faculty

Stephen J Pomeranz, MD

Chief Medical Officer, ProScan Imaging. Founder, MRI Online

ProScan Imaging

Tags

Musculoskeletal (MSK)

MRI

Idiopathic

Hand & Wrist

Congenital

Acquired/Developmental

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