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MRI Wrist TFCC Anatomy

The MRI anatomy of the TFCC is important to know before we start talking about TFCC abnormalities. Today’s post is on the normal anatomy of the TFCC which is composed of a number of structures.

mri wrist tfcc normal radiology education asia

Image Above: Triangular fibrocartilage ( blue arrow) also called articular disc. Ulnar side thicker than radial. Radial side attaches to  radial articular cartilage.

mri wrist tfc normal radiology education asia

Image Above: TFC Fuses with Volar RadioUlnar Ligament and with Dorsal Radioulnar ligament on dorsal side.

mri wrist tfc triangular ligament normal radiology education asia

Image Above: Triangular ligaments are the ulnar attachment of the TFC to the ulnar styloid ( red arrow) and the fovea ( ligament yellow arrow, fovea pink arrow). In between the foveal and styloid attachments is the Ligamentum Subcruentem.

mri wrist tfc meniscal homologue pre styloid recess normal radiology education asiaImage Above: Pre styloid recess ( red arrow) Meniscal Homologue ( blue arrow) ill defined thickening arises from ulnar styloid and merges with Triquetrum. ECU ( yellow arrow).

mri wrist tfc triangular ligament ulnotriquetral ulnolunate ligament normal radiology education asiaImage Above: Ulnolunate ( blue arrow sagittal scan) and Ulnotriquetral ( pink arrow coronal and sagittal). Difficult to see on coronal scans as they run in plane. Can be easier on sagittal. Combination of Ulnolunate, Ulnotriquetral and UlnoCapitate ligaments called Ulnocarpal ligamentous complex. Cant distinguish one from another as they are fused.

Ulnar Collateral Ligament is mentioned in texts but is not seen on MRI and may not exist.

All diagrams from Zhan HL et al. High‐resolution 3T Magnetic Resonance Imaging of the Triangular Fibrocartilage Complex in Chinese Wrists: Correlation with Cross‐sectional Anatomy. Chin Med J 2017;130:817‐22.

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December 9, 2017