SPR Unknown # 99 -- FINAL

John D. MacKenzie, MD

UCSF Benioff Children's Hospital

Peter Marcovici, MD

UCSF Benioff Children's Hospital


Publication Date: 2013-11-06

History

9 year old female with a reported history of a right wrist TFCC tear. Longstanding right wrist pain, for at least one year. The pain is located over the ulnar aspect of the right wrist. A clinic note described the findings of an outside MRI of the wrist as "Perforation of the TFCC central disc near the radial attachment. No associated chondromalacia, joint effusion or synovitis. Mild positive ulnar variance."

MRI of both wrists was performed. Left is shown first, then right.

Findings

MRI shows absence of the central/radial portion of the triangular fibrocartilage disc. The remaining portions of the complex are intact. There is lack of adjacent bone marrow edema, and no articular cartilage loss, or other sign of degenerative arthropathy.

Diagnosis

Congenital meniscoid articular disc of the TFCC

Discussion

A meniscoid configuration of the TFCC is considered a congenital anatomical variant. This variant configuration may be overdiagnosed as a traumatic tear. Examination of the contralateral (asymptomatic) side by MRI may show similar findings as the index side, which is supportive of the diagnosis.

Files

References

  1. Kim SJ, Moon HK, Chun YM, Chang WH, Kim SG, Lee SK. Congenital meniscoid articular disc of the triangular fibrocartilage complex. J Bone Joint Surg Br. 2009 Aug;91(8):1094-6.

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