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.
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
ProScan Imaging
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