Download PDF
CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2023; 33(01): 129-131
DOI: 10.1055/s-0042-1759484
Case Report

It Is Not Only the Meniscus That Flips—A Case of TFCC Tear with a Flipped Fragment in the Distal Radioulnar Joint

Aakanksha Agarwal
1   Department of Radiology, University of British Columbia, St. Paul's Hospital, Vancouver, Canada
,
Abhishek Chandra
2   Department of Orthopedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
,
Timothy Murray
1   Department of Radiology, University of British Columbia, St. Paul's Hospital, Vancouver, Canada
,
Mark Cresswell 
1   Department of Radiology, University of British Columbia, St. Paul's Hospital, Vancouver, Canada
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Acute wrist injuries with ongoing ulnar-sided wrist pain warrant a magnetic resonance imaging (MRI) to diagnose ligamentous injuries. Triangular fibrocartilage complex (TFCC) tears have been classified and described in the literature but complex tear patterns have limited representation. Bucket-handle tears of the TFCC represent only 0.5% of TFCC tears and have recently been identified, posing a diagnostic and management challenge. Preoperative diagnosis is possible with MRI and necessary for optimal and early surgical management. The authors describe a unique case of a flipped tear of the central disc of the TFCC, where the fragment was flipped into the distal radioulnar joint, a site hidden during routine arthroscopy.

Keywords

triangular fibrocartilage tear - flipped TFCC - MRI in TFCC tear


Publication History

Article published online:
07 December 2022

© 2022. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Palmer AK. Triangular fibrocartilage complex lesions: a classification. J Hand Surg Am 1989; 14 (04) 594-606
    CrossrefPubMedGoogle Scholar
  • 2 Atzei A, Luchetti R. Foveal TFCC tear classification and treatment. Hand Clin 2011; 27 (03) 263-272
    Google Scholar
  • 3 Boutin RD, Fritz RC. Displaced flap tears of the triangular fibrocartilage complex: frequency, flap location, and the “Comma” sign on wrist MRI. AJR Am J Roentgenol 2021; 217 (03) 707-708
    CrossrefPubMedGoogle Scholar
  • 4 Jose J, Arizpe A, Barrera CM, Ezuddin NS, Chen D. MRI findings in bucket-handle tears of the triangular fibrocartilage complex. Skeletal Radiol 2018; 47 (03) 419-424
    CrossrefPubMedGoogle Scholar
  • 5 Vezeridis PS, Yoshioka H, Han R, Blazar P. Ulnar-sided wrist pain. Part I: anatomy and physical examination. Skeletal Radiol 2010; 39 (08) 733-745
    CrossrefPubMedGoogle Scholar
  • 6 Sachar K. Ulnar-sided wrist pain: evaluation and treatment of triangular fibrocartilage complex tears, ulnocarpal impaction syndrome, and lunotriquetral ligament tears. J Hand Surg Am 2008; 33 (09) 1669-1679
    CrossrefPubMedGoogle Scholar
  • 7 Tay SC, Tomita K, Berger RA. The “ulnar fovea sign” for defining ulnar wrist pain: an analysis of sensitivity and specificity. J Hand Surg Am 2007; 32 (04) 438-444
    CrossrefPubMedGoogle Scholar
  • 8 Watanabe A, Souza F, Vezeridis PS, Blazar P, Yoshioka H. Ulnar-sided wrist pain. II. Clinical imaging and treatment. Skeletal Radiol 2010; 39 (09) 837-857
    CrossrefPubMedGoogle Scholar
  • 9 Theumann N, Kamel EM, Bollmann C, Sturzenegger M, Becce F. Bucket-handle tear of the triangular fibrocartilage complex: case report of a complex peripheral injury with separation of the distal radioulnar ligaments from the articular disc. Skeletal Radiol 2011; 40 (12) 1617-1621
    CrossrefPubMedGoogle Scholar
  • 10 Meadows M. Displaced Triangular Fibrocartilage Cartilage Complex Tears [Internet]. Radsource. 2022 [cited 2022 Jul 9]. Accessed October 13, 2022 at: https://radsource.us/displaced-triangular-fibrocartilage-cartilage-complex-tears/