Article
Changes in the morphology of the triangular fibrocartilage complex (TFCC) on magnetic resonance arthrography related to disruption of ulnar foveal attachment
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Published: | February 6, 2020 |
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Objectives/Interrogation: The proximal ligamentous complex (PLC) of the triangular fibrocartilage complex (TFCC) inserts into the ulnar fovea and is the primary restraint of the distal radioulnar joint (DRUJ). The aim of this study was to assess whether a PLC with a distally prolapsing morphology is associated with the presence of a TFCC foveal tear on arthroscopy.
Methods: One-hundred thirty-two patients (134 wrists) who underwent MR arthrography and subsequent wrist arthroscopy between September 2014 and March 2018 were evaluated retrospectively. Distal prolapse amount of the PLC was measured on coronal MR arthrography by calculating the height-to-length ratio (HLR). Subjects' demographics, ulnar variance, presence of a degenerative TFCC tear, and ulnar styloid nonunion were assessed. The association between specific variables and the presence of a foveal tear was investigated.
Results and Conclusions: Arthroscopy revealed a TFCC foveal tear in 101 wrists among 134 wrists. Univariable analysis showed that the HLR of the PLC was significantly greater in the foveal tear group than the intact fovea group (p < 0.05). Multivariable analysis showed that HLR had a positive association with a foveal tear (p < 0.001). Estimated cut-off value for the HLR was 41% (area under the curve [AUC] 0.77).
A PLC that has a distal prolapse pattern with a large HLR is associated with TFCC foveal tears. HLR of the PLC measured on coronal MR images can therefore be used as an additional predictor of tears of the foveal attachment of the TFCC.