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Cine MRI of the Triangular Fibrocartilage Complex during Radial-Ulnar Deviation
Toshiyasu Nakamura1, Koji Abe2, Nobuki Terada3
1Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Tokyo, Japan.
Journal of Wrist Surgery
|September 28, 2018
Summary
Cine MRI reveals dynamic changes in the triangular fibrocartilage complex (TFCC) shape during wrist deviation. Abnormal TFCC movements in ulnar deviation may indicate tears or nonunion, correlating with positive ulnocarpal stress tests.
Area of Science:
- Orthopedics
- Radiology
- Anatomy
Background:
- The triangular fibrocartilage complex (TFCC) is crucial for wrist stability and function.
- Understanding TFCC dynamics during motion is essential for diagnosing wrist injuries.
Purpose of the Study:
- To investigate dynamic changes in TFCC shape during radial-ulnar deviation using cine-mode MRI.
- To differentiate normal TFCC motion from abnormal motion in patients with TFCC tears or ulnar styloid nonunion.
Main Methods:
- Utilized cine-mode MRI to capture dynamic TFCC shape changes across nine radial-ulnar deviation positions.
- Studied 10 healthy volunteers, 5 patients with TFCC tears, and 5 with ulnar styloid nonunion.
- Employed a custom device to restrict wrist motion to radial and ulnar deviation only.
Main Results:
- Normal TFCC elongated in radial deviation and shortened in ulnar deviation.
- Abnormal wavy deformities were observed in the TFCC disc during ulnar deviation in patients with tears.
- Ulnar styloid nonunion cases showed fragment displacement or space elongation in maximum ulnar deviation.
Conclusions:
- Cine MRI effectively visualizes normal and abnormal dynamic TFCC changes during wrist deviation.
- Abnormal TFCC dynamics, particularly in ulnar deviation, are linked to wrist pathology and positive ulnocarpal stress tests.
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