TRIANGULAR FIBROCARTILAGE COMPLEX- MRI

Teaching points about TFCC by Dr MGK Murthy & Mr Abdul Hamid

- Normally responsible for ulnar sided wrist pain.

- Thickness is inversely related to ulnar variance with negative ulnar variance patients  having thicker TFCC.

- Normally is 1 to 2 mm thick at most locations with subtle increased upto 5 mm in the vicinity of eccentric concavity of the ulnar styloid.

- Being of type-I collagen is usually dark on all sequences like  the knee ligaement.

- Coronal fat suppressed sequence is most appropriate for study of TFCC.

- The blood supply is usually well maintained at the periphery with relatively avascular centre which leads to central perforations not healing well.

- Dorsal and the palmar branches of the anterior introsseous artery along with dorsal and the palmar branches of ulnar artery supply TFCC. 

- Has attachments to lunate, triquetral, hamate and base of the 5^th metacarpal.

- Closely approximated to extensor carpi ulnaris tendon and associated injuries are common.

- MDCT Arthrography of the wrist  is suggested to be superior in some studies, to MR Arthrography or Conventional Arthrography.

- Degeneration starts in 3^rd decade with heterogenity being the rule by the 4^th decade.