50-year-old male, locks rotation at wrist after radial head fracture. Evaluate for TFCC tear. Evaluation of the wrist is limited due to the inability to optimally position the patient. A flex coil was utilized instead of a wrist coil.Mild to moderate osteoarthritis affects the distal radioulnar joint with subchondral cysts within the distal ulna that are associated with mild edema. Best seen on the fat-saturated T2-weighted axial images is high signal intensity along the volar aspect of the distal ulna, between the extensor digiti minimi and extensor carpi ulnaris tendons, that we suspect represents synovitis extending from the distal radioulnar joint. The triangular fibrocartilage fibers can be followed from their radial insertion to their ulnar styloid attachment. There is mild increased signal intensity along the proximal surface of the articular disc, near its ulnar attachment, which may represent mild fraying, but we see no complete fluid-filled tear. There is a small amount of fluid within the tendon sheath of the extensor carpi ulnaris, which may reflect a very mild tenosynovitis with a small amount of increased signal intensity within the tendon suggesting a mild tendinosis. There is also increased signal intensity along the inferior margin of the pisotriquetral articulation which may reflect a mild synovitis within the inferior recess. There is a small amount of fluid within the radiocarpal joint as well as a small amount of synovitis along the scaphoid. We see no carpal bone erosions. The bone marrow signal intensity is otherwise normal. The remaining tendons are within normal limits. We suspect that there is a persistent median artery coursing within the median nerve. Evaluation of the interosseous ligaments is limited but we see no findings to suggest a scapholunate or lunotriquetral ligament disruption. There is a small ossicle seen on prior radiographs which appears to lie volar to the volar radioulnar ligament and probably is of no clinical significance.
1. Limited study as described above. Osteoarthritis of the distal radioulnar joint with what appears to be synovitis extending volarly from the joint. There may be mild proximal fraying of the triangular fibrocartilage complex, but no complete fluid-filled tear is evident.2. Minimal tenosynovitis and tendinosis of the extensor carpi ulnaris.3. Mild synovitis of the radiocarpal joint.