0:00

A magnified, coronal, water

0:03

weighted MRI view of the TFC.

0:07

Let's start off simple.

0:08

On the radial side, we've got some higher signal

0:11

intensity hyaline cartilage, and the attachment to it

0:15

looks a little bit like a goblet lying on its side.

0:19

Remember that avulsions, or separations, here are rare.

0:25

Most tears are going to be here or here, in

0:28

the middle or central one-third of the TFC.

0:32

Volume averaged, we have hyaline cartilage,

0:36

and capsulocynovial tissue, which we can't really see.

0:41

And the same thing on the ulnar side, or proximal

0:45

margin, of the triangular fibrocartilage.

0:48

Then within our yellow circle, we've

0:51

got some peripheral attachments.

0:54

And these include some distal ones to the, to

0:56

the styloid, which we can see are somewhat wispy.

1:00

These form the superficial layer of the

1:03

peripheral attachment, part of which

1:05

is composed of the volar and dorsal.

1:10

The deeper layer, which I'll pick another color

1:13

for, is formed by a group of folds that come

1:20

off the tip of the triangular fibrocartilage.

1:22

So here's the tip.

1:24

These folds are often a little bit kinked, and you

1:26

can see they are a little bit kinked and irregular.

1:29

They're highlighted by a little bit of inflammation.

1:31

And these tiny little wispy areas that we

1:34

see here, I'll color over them right now and

1:36

say yellow, right there, these are vessels.

1:40

Those vessels mix together with these other

1:43

kinked or folded structures to insert onto

1:47

the fovea near the forearm axis of rotation.

1:50

This is the deep layer of the peripheral attachment

1:53

of the TFC known as the ligamentum subcruentum.

1:59

The rest of the anatomy consists of filler,

2:03

including, and I'll draw over it, we'll call

2:06

it gray since it's kind of uninteresting,

2:09

the ulnomeniscus homologue, surrounded by some

2:13

slightly brighter tissue. We'll make it darker gray.

2:16

The joint capsule, and they're kind of mixed

2:18

together to kind of fill in this, this space.

2:23

We also visualize the lunotriquetral ligament.

2:26

Well, we'll make that green, there it is.

2:29

And the lunato triquetral ligament has an

2:31

attachment back to the TFC, which is this

2:34

darker tissue that I've just colored over.

2:37

The ulnar carpal ligament, of which

2:38

there is a palmar and a dorsal one.

2:41

How's that for magnified MRI?

Triangular Fibrocartilage: Magnified MRI

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0:00

A magnified, coronal, water

0:03

weighted MRI view of the TFC.

0:07

Let's start off simple.

0:08

On the radial side, we've got some higher signal

0:11

intensity hyaline cartilage, and the attachment to it

0:15

looks a little bit like a goblet lying on its side.

0:19

Remember that avulsions, or separations, here are rare.

0:25

Most tears are going to be here or here, in

0:28

the middle or central one-third of the TFC.

0:32

Volume averaged, we have hyaline cartilage,

0:36

and capsulocynovial tissue, which we can't really see.

0:41

And the same thing on the ulnar side, or proximal

0:45

margin, of the triangular fibrocartilage.

0:48

Then within our yellow circle, we've

0:51

got some peripheral attachments.

0:54

And these include some distal ones to the, to

0:56

the styloid, which we can see are somewhat wispy.

1:00

These form the superficial layer of the

1:03

peripheral attachment, part of which

1:05

is composed of the volar and dorsal.

1:10

The deeper layer, which I'll pick another color

1:13

for, is formed by a group of folds that come

1:20

off the tip of the triangular fibrocartilage.

1:22

So here's the tip.

1:24

These folds are often a little bit kinked, and you

1:26

can see they are a little bit kinked and irregular.

1:29

They're highlighted by a little bit of inflammation.

1:31

And these tiny little wispy areas that we

1:34

see here, I'll color over them right now and

1:36

say yellow, right there, these are vessels.

1:40

Those vessels mix together with these other

1:43

kinked or folded structures to insert onto

1:47

the fovea near the forearm axis of rotation.

1:50

This is the deep layer of the peripheral attachment

1:53

of the TFC known as the ligamentum subcruentum.

1:59

The rest of the anatomy consists of filler,

2:03

including, and I'll draw over it, we'll call

2:06

it gray since it's kind of uninteresting,

2:09

the ulnomeniscus homologue, surrounded by some

2:13

slightly brighter tissue. We'll make it darker gray.

2:16

The joint capsule, and they're kind of mixed

2:18

together to kind of fill in this, this space.

2:23

We also visualize the lunotriquetral ligament.

2:26

Well, we'll make that green, there it is.

2:29

And the lunato triquetral ligament has an

2:31

attachment back to the TFC, which is this

2:34

darker tissue that I've just colored over.

2:37

The ulnar carpal ligament, of which

2:38

there is a palmar and a dorsal one.

2:41

How's that for magnified MRI?

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Faculty

Stephen J Pomeranz, MD

Chief Medical Officer, ProScan Imaging. Founder, MRI Online

ProScan Imaging

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Triangular Fibrocartilage: Magnified MRI