*24-year-old male with ulnar sided wrist pain.
What is the most likely diagnosis?
Answer
Answer: TFCC tear (Palmer Ia)
Case Discussion:
MR images showed a full-thickness tear of the central portion of the TFC, with intact radial and ulnar attachments. Effusion within the distal radio-ulnar joint. Normal bone signal.
Class 1 – traumatic injury
a: central perforation
b: ulnar avulsion with or without distal ulnar fracture
c: distal avulsion
d: radial avulsion with or without sigmoid notch fracture
Class 2 – degenerative injury
a: TFCC wear
b: TFCC wear with lunate and/or ulnar chondromalacia
c: TFCC perforation with lunate and/or ulnar chondromalacia
d: TFCC perforation with lunate and/or ulnar chondromalacia and lunotriquetral ligament perforation
e: TFCC perforation with lunate and/or ulnar chondromalacia, lunotriquetral ligament perforation, and ulnocarpal arthritis
References:
1. 1. Oneson SR, Scales LM, Timins ME et-al. MR imaging interpretation of the Palmer classification of triangular fibrocartilage complex lesions. Radiographics. 1996;16 (1): 97-106.
2. Burns JE, Tanaka T, Ueno T et-al. Pitfalls that may mimic injuries of the triangular fibrocartilage and proximal intrinsic wrist ligaments at MR imaging. Radiographics. 2011;31 (1): 63-78.