https://youtube.com/shorts/19TwSM3CQRU
Scapholunate Ligament:
1. Three Distinct Components
The SLL has dorsal, volar, and proximal (membranous) segments, each with unique structure and function.
2. Dorsal Component – The Key Stabilizer
- Thickest and strongest portion
- Short, bandlike, and low signal on MRI
- Controls translation and resists scaphoid flexion
- Most commonly completely torn in symptomatic instability
3. Volar Component – Rotation Controller
- Much thinner (≤1 mm) with oblique collagen fibers
- Controls segmental rotation and contributes to proprioception
- Often shows striated, heterogeneous increased signal (normal)
- Must not be confused with the overlying radiolunotriquetral (RLT) ligament
4. Proximal/Membranous Component – Weakest Segment
- Fibrocartilaginous and meniscus-like
- Wedge- or triangular-shaped on imaging
- Inserts on hyaline cartilage rather than cortical bone
- Common site of degenerative perforation
- Minimal role in stability
5. Important MRI Pitfall
The RLT ligament lies intimately over the volar SLL, so careful distinction is required to avoid falsely diagnosing a volar SLL tear.
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Visualizing MSK Radiology: A Practical Guide to Radiology Mastery
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