R Schmitt1,2, J P Grunz3, K Luetkens3, E Haas-Lützenberger4, N Hesse5. 1. Klinik und Poliklinik für Radiologie, Ludwig-Maximilians-Universität München, Nußbaumstraße 20, 80336, München, Deutschland. radiodiagnostics@outlook.com. 2. Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Würzburg, Würzburg, Deutschland. radiodiagnostics@outlook.com. 3. Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Würzburg, Würzburg, Deutschland. 4. Abteilung für Handchirurgie, Plastische und Ästhetische Chirurgie, Ludwig-Maximilians-Universität München, München, Deutschland. 5. Klinik und Poliklinik für Radiologie, Ludwig-Maximilians-Universität München, Nußbaumstraße 20, 80336, München, Deutschland.
Abstract
CLINICAL ISSUE: The triangular fibrocartilage complex (TFCC) is an anatomically complex structure with high demands on spatial and contrast resolution in imaging. RADIOLOGICAL METHODS: The central, predominantly avascular articular disc can be distinguished from the ligamentous, vascularized periphery. Imaging methods include magnetic resonance imaging (MRI, preferably contrast-enhanced) as well as MR and computed tomography (CT) arthrography. DIAGNOSTIC INNOVATIONS: While high-resolution MRI represents the standard diagnostic tool for the TFCC in general, arthrographic imaging is particularly useful for assessment of the foveal (proximal) lamina of the TFCC. In radiological reporting, the convergence of the TFCC periphery towards the ulnar styloid process and the ulnar fovea must be considered. ACHIEVEMENTS: The Palmer classification is suitable for evaluating lesions of the articular disc, whereas the Atzei classification is superior for lesions of the ulnar TFCC insertions. PRACTICAL RECOMMENDATION: Use of a high-resolution examination technique and anatomy-based image interpretation are important for reliable MRI of the TFCC.
CLINICAL ISSUE: The triangular fibrocartilage complex (TFCC) is an anatomically complex structure with high demands on spatial and contrast resolution in imaging. RADIOLOGICAL METHODS: The central, predominantly avascular articular disc can be distinguished from the ligamentous, vascularized periphery. Imaging methods include magnetic resonance imaging (MRI, preferably contrast-enhanced) as well as MR and computed tomography (CT) arthrography. DIAGNOSTIC INNOVATIONS: While high-resolution MRI represents the standard diagnostic tool for the TFCC in general, arthrographic imaging is particularly useful for assessment of the foveal (proximal) lamina of the TFCC. In radiological reporting, the convergence of the TFCC periphery towards the ulnar styloid process and the ulnar fovea must be considered. ACHIEVEMENTS: The Palmer classification is suitable for evaluating lesions of the articular disc, whereas the Atzei classification is superior for lesions of the ulnar TFCC insertions. PRACTICAL RECOMMENDATION: Use of a high-resolution examination technique and anatomy-based image interpretation are important for reliable MRI of the TFCC.
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