Female 15 years old Reason: eval for tfcc tear; cyst History: wrist pain druj and swelling in area of tfcc. TRIANGULAR FIBROCARTILAGE COMPLEX: There is dorsal subluxation of the distal ulna relative to the sigmoid notch of the radius. There is positive ulnar variance. The volar and dorsal radioulnar ligaments are grossly intact at their radial attachments. The intervening articular disk of the triangular fibrocartilage complex has laminar increased signal intensity that we suspect reflects intrasubstance degeneration. We see no gadolinium entering the substance of the triangular fibrocartilage complex to indicate a tear. LIGAMENTS: Contrast is noted within the radiocarpal joint as expected. Although no contrast was seen in the midcarpal joint on conventional arthrogram, contrast is identified in the mid carpal joint on this study. We suspect that this reflects a small tear of the lunotriquetral ligament, perhaps most evident on image 8, series 601. The scapholunate ligament appears intact.TENDONS: The tendons and remaining soft tissue structures appear normal. BONES: There is mild edema type signal in the ulnar styloid which may relate to the aforementioned degeneration of the triangular fibrocartilage complex. There is also a small defect along the margin of the triquetrum with small cysts in the underlying marrow. The signal intensity of the bone marrow is otherwise within normal limits.
Positive ulnar variance and dorsal subluxation of the distal ulna with degeneration of the triangular fibrocartilage complex articular disk and probable tear of the lunotriquetral ligament. Signal intensity within the ulnar styloid and triquetrum may reflect ulnar abutment.