On the ulnar attachment, TFCC attaches onto the ulnar styloid process through the distal lamina and onto the fovea of distal ulna through the proximal lamina; they are separated by the ligamentum subcruentum.
The most important structure of the TFCC is the triangular fibrocartilage (TFC) proper, a triangular-shaped piece of fibrocartilage.
On the radial side, the triangular fibrocartilage or articular disc of the TFCC has a broad attachment to the hyaline cartilage of the sigmoid notch of the distal radius.
The thickness of the articular disk of the TFCC depends on the degree of ulnar variance. It is thicker and less prone to tear in people with an ulnar negative variance.
The TFC proper attaches to the dorsal and volar radioulnar ligaments, which are peripheral thickenings
Since the volar and dorsal radioulnar ligaments are so closely integrated with the articular disc, some authors consider this as simply thick, strong marginal portions of the disc Dorsal and ulnar radioulnar ligaments are inseparable from the articular disc.
articular disk of the TFCC attaches onto and is inseparable from the dRUL, reinforced by the radiotriquetral ligament.
On the ulnar side, the articular disk attaches to the distal ulna by two distinct bands or laminae, that is, the proximal lamina (or foveal fibers) that attaches to the fovea and the distal lamina (or styloid fibers) that attaches to the midportion of the ulnar styloid process. They are separated by the ligamentum subcruentum, a highly vascularized area made of loose areolar connective tissue.
The ulnar styloid tip has intermediate signal intensity hyaline cartilage, and should not be interpreted as a tear of the distal lamina.
If there is a small amount of fluid in the presyloid recess at the volar aspect of the ulnar styloid process, it may also look like the tear of the distal lamina.
It is important to know the anatomy here because there are several pitfalls around the ulnar styoid process tip that look similar to the distal lamina tear.
In the coronal plane, the ulnomeniscal homologue has a typical triangular shape, with the base of the triangle located along the ECU tendon sheath.
Ulnomeniscal homologue lies just ulnar to the prestyloid recess.
The triangular fibrocartilage is reinforced by meniscal homologue.
It has a common origin with the dorsal radioulnar ligament on the ulnar and dorsal aspect of the radius and inserts on the ulnar border of the triquetrum and 5th metacarpal base.
It adheres to the ulnar joint capsule and merges with the ulnar collateral ligament (UCL) and the sheath of the extensor carpi ulnaris (ECU) tendon.
The ulnar collateral ligament (UCL) may not be a distinct anatomical structure located in between the extensor carpi ulnaris tendon (ECU) sheath and the UMH.
These structures normally cannot be differentiated by imaging.
The prestyloid recess is a synovial-lined pouch with a direct connection to the rest of the radiocarpal compartment. It is most commonly a saccular space bordered by the meniscal homologue distally, the TFCC attachments to the ulnar styloid process proximally, and the central TFCC disk radially
There are several variations in the shape of the prestyloid recess
The membranous component most commonly appears as a triangular or deltoid region of low signal intensity.
The membranous component of the LTL shows a broad spectrum of normal variations in shape on coronal images.
The LTL segments could be viewed as the reverse of the SLL segments, in that the volar LTL is thicker and potentially more important than the dorsal LTL, whereas the dorsal SLL is thicker than the volar SLL
The dorsal and volar components of the LTL are true ligamentous components, consisting of collagen fascicles.
The histologic nature of the membranous component of the LTL is different from that of the volar and dorsal components; it consists of fibrocartilaginous tissue similar to that of the triangular fibrocartilage.
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