Case 20-patient with right wrist discomfort.

Patient presents with left  wrist discomfort after a FOOSH type injury. 

No prior surgeries,  carcinoma  or corticosteroid/opioid regimen reported.

What do you see?

A semi-lunar density is seen where the normal left ulnar styloid process should normal be. Malunion or non-union of the ulnar styloid process is common after FOOSH injury. Associated triangular fibrocartilage injuries commonly associated.

Wrist- anatomic model- dorsal perspective. The white horizontal density represents the triangular fibro-cartilage (TFC). (3)

Coronal fat-sat MRI- arrows pointing to normal structures on ulnar side of wrist.

Coronal Fat-Sat image. The arrow demonstrates a complete tear of the radial side of the TFC. (1)

DISCUSSION:

TFC injuries are usually degenerative or post-traumatic. Normal  variants in this region must be differentiated on MRI for accurate diagnosis. (2) Because MRI is invaluable in detecting & locating TFC tears, this helps in non-operative & operative decision making for the clinician. (1)

REFERENCES:

  1. https://radsource.us/triangular-fibrocartilage-tear/https://pubs.rsna.org/doi/full/10.1148/rg.311105114
  2. https://pubs.rsna.org/doi/full/10.1148/rg.311105114
  3. https://www.sportsinjuryclinic.net/sport-injuries/wrist-pain/acute-wrist-injuries/tfcc-tear
  4. https://pubs.rsna.org/doi/full/10.1148/rg.311105

Will another DC benefit from this case?

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