Ultrasound of the Triangular Fibrocartilage Complex (TFCC) of the Wrist: Protocol and Tear Features — МЕДТРЕЙН Asia
Musculoskeletal Ultrasound

Ultrasound of the Triangular Fibrocartilage Complex (TFCC) of the Wrist: Protocol and Tear Features

Briefly. The TFCC is evaluated during wrist ultrasound with reference points on the distal ulna, triquetrum, lunate, and the extensor carpi ulnaris tendon. However, the provided source fragments do not contain a specific scanning protocol for the TFCC or sonographic criteria for its tear, so key details require clarification [clarify].

Anatomical Landmarks

In the available fragments describing the ulnar zone of the wrist, anatomical landmarks are provided, which are used as reference structures during scanning: the extensor carpi ulnaris tendon (E), lunate (L), radius (R), triquetrum (T), and ulna (U). These structures form the topographical context of the ulnar part of the wrist where the TFCC is located.

TFCC Examination Protocol

The specific scanning protocol for the TFCC (patient position, transducer orientation, standard planes, dynamic maneuvers) is not described in the provided source fragments [clarify]. By analogy with the general principles of wrist ligament ultrasound, the technique for examining intra- and extracarpal ligaments and the TFCC is noted, but detailed steps are not provided in the text [clarify].

As a methodological reference, the fragments mention a publication dedicated to the normal anatomy and imaging technique of intra- and extracarpal ligaments of the wrist and the triangular fibrocartilage complex (Taljanovic MS, et al. US of the intrinsic and extrinsic wrist ligaments and triangular fibrocartilage complex — normal anatomy and imaging technique. Radiographics. 2011;31(1):e44).

Tear Features

Specific sonographic criteria for TFCC tears (e.g., nature of fibrocartilage discontinuity, presence of fluid, change in echo structure) are not outlined in the provided fragments [clarify]. From related sections of the source, only general principles of visualizing ligamentous-capsular injuries can be noted: for instance, in injuries, capsular rupture is described ("indicates capsular rupture") and avulsion fractures in the projection of ligaments appear as avulsed bone fragments on long-axis images of the ligament.

Associated Ulnar Forearm Injuries

The fragments provide data on accompanying forearm conditions that may be associated with ulnar pathology. In the case of interosseous membrane rupture (Essex-Lopresti injury), on an oblique-transverse image on the dorsal surface of the middle third of the forearm, the interosseous membrane is not identified, unlike the normal appearance on the contralateral asymptomatic side.

LandmarkDesignation in Fragment
Extensor carpi ulnaris tendonE (extensor carpi ulnaris tendon)
LunateL (lunate)
RadiusR (radius)
TriquetrumT (triquetrum)
UlnaU (ulna)

Frequently asked questions

What anatomical landmarks should be used when scanning the ulnar zone of the wrist?

According to the source fragments, the reference structures are the extensor carpi ulnaris tendon (E), lunate (L), triquetrum (T), as well as the radius (R) and ulna (U).

Is there a detailed scanning protocol for the TFCC in the source?

No. The provided fragments do not outline a step-by-step protocol (transducer position, planes, dynamic maneuvers) — these details require clarification [clarify].

What ultrasound features of TFCC tears are mentioned in the fragments?

Specific criteria for TFCC tears specifically are absent in the fragments [clarify]. From related sections, only general features are mentioned: capsular rupture and avulsion fractures in the projection of ligaments.

How does an interosseous membrane rupture of the forearm appear on ultrasound?

In Essex-Lopresti injury, on an oblique-transverse image on the dorsal surface of the middle third of the forearm, the interosseous membrane is not identified, unlike the normal appearance on the contralateral side.

Which source is recommended for the anatomy and imaging technique of the TFCC?

The fragments mention the article by Taljanovic MS et al., Radiographics 2011;31(1):e44 — on the normal anatomy and ultrasound technique of wrist ligaments and the TFCC.

The material is intended for specialists and does not replace clinical judgment. Threshold values are periodically reviewed — refer to the current edition of the applicable consensus.
Sources: Fundamentals of Musculoskeletal Ultrasound, Fourth Edition (Jon A. Jacobson, 2026); Diagnostic Ultrasound: Musculoskeletal, Third Edition (James F. Griffith, 2025); Taljanovic MS et al. Radiographics. 2011;31(1):e44.
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