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Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
Continuing Medical Education (State CME)
Complete all of your state CME requirements in one convenient place.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Case Crunch: Rapid Case Review (Free)
Register for free live board reviews.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Compliance
NewTrack, fulfill, and report on all your radiologists' credentialing and licensing requirements.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Start Here
Start Here
3 topics, 3 min. of video
Practice Cases
Week 1
6 topics, 27 min. of video
Practice Cases
Week 2
7 topics, 11 min. of video
Practice Cases
Week 3
6 topics, 17 min. of video
Practice Cases
Week 4
6 topics, 15 min. of video
Practice Cases
Week 5
7 topics, 9 min. of video
End of Course Activities
Course Evaluation
1 topic
0:00
These are images of the wrist on a 35 year old with ulnar sided
0:05
pain.
0:06
The main findings here are edema of the ulnar
0:11
insertion, advance of the triangular fibrocartilage at the fovea,
0:16
and also at the tip. So on al images,
0:21
it's very important to track the insertion advance of the
0:25
triangular fibro cartilage complex from Palmer to dorsal.
0:30
And we can see here that's the tip of the ulnar tylo with
0:34
cross-referencing on the cytal and axial planes.
0:38
There is some marma of the tip of the nar styloid,
0:43
and we can see integrity of the fibers attaching to the tip,
0:48
but partial discontinuity of the fibers inserting into the foia.
0:53
So this patient has a sprain of the triangular fibrocartilage complex,
0:58
evolving the ulnar sided insertion,
1:01
advance radial insertion. Advance is completely normal.
1:06
Central disc is also intact.
1:09
And this explains the presence of symptoms referred to the
1:14
ulnar styloid, ulnar sided wrist.
1:17
Sagittal images allow us also to assess this insertion band.
1:22
So this is the ulnar styloid tip insertion edema,
1:27
but not discontinuity.
1:28
And then we have more proximally the attachment to the FOA where we're seeing
1:34
a small partial thing is there with focal discontinuity of the fibers.
Wk 5, Case 1 - Review
HIDEInteractive Transcript
0:00
These are images of the wrist on a 35 year old with ulnar sided
0:05
pain.
0:06
The main findings here are edema of the ulnar
0:11
insertion, advance of the triangular fibrocartilage at the fovea,
0:16
and also at the tip. So on al images,
0:21
it's very important to track the insertion advance of the
0:25
triangular fibro cartilage complex from Palmer to dorsal.
0:30
And we can see here that's the tip of the ulnar tylo with
0:34
cross-referencing on the cytal and axial planes.
0:38
There is some marma of the tip of the nar styloid,
0:43
and we can see integrity of the fibers attaching to the tip,
0:48
but partial discontinuity of the fibers inserting into the foia.
0:53
So this patient has a sprain of the triangular fibrocartilage complex,
0:58
evolving the ulnar sided insertion,
1:01
advance radial insertion. Advance is completely normal.
1:06
Central disc is also intact.
1:09
And this explains the presence of symptoms referred to the
1:14
ulnar styloid, ulnar sided wrist.
1:17
Sagittal images allow us also to assess this insertion band.
1:22
So this is the ulnar styloid tip insertion edema,
1:27
but not discontinuity.
1:28
And then we have more proximally the attachment to the FOA where we're seeing
1:34
a small partial thing is there with focal discontinuity of the fibers.
Report
Patient History
35-year-old female with forearm discomfort and wrist pain
Findings
ALIGNMENT:
Ulnar Variance: Neutral.
Distal Radioulnar Joint: Normal alignment.
Carpal Instability: None.
ARTICULATIONS:
Thumb Carpometacarpal Joint: Normal.
Scaphotrapeziotrapezoidal Joint: Normal.
Pisiform-Triquetral Joint: Normal.
Radiocarpal Joint: Normal.
Distal Radioulnar Joint: Low-grade strain of the dorsal radioulnar ligament.
Fluid: A small 1.1cm ganglion pseudocyst at the volar aspect of the capitatohamate joint.
Carpal Effusion: None.
Distal Radioulnar Joint Effusion: None.
INTRINSIC LIGAMENTS:
Scapholunate Ligament: Intact.
Lunotriquetral Ligament: Intact.
Triangular Fibrocartilage: High-grade strain or avulsion of the proximal and distal lamina also known as the foveal and styloid attachments, respectively of the triangular ligament of the triangular fibrocartilage complex with edema throughout the meniscus homologous and ulnar collateral ligament.
TFC disc proper is intact.
Lunate Facet: Normal.
Hamate-Lunate Facet: Normal.
Extensor Compartment: No evidence of tendinosis, tenosynovitis or tendon tears.
Flexor Compartment: No evidence of tendinosis, tenosynovitis or tendon tears.
Carpal Tunnel: No space-occupying lesions
Median Nerve: Normal.
Flexor Retinaculum: No thickening or volar bowing.
Flexor Tendons: Normal.
Guyon's Canal: Normal.
OTHER FINDINGS:
Skeleton: No fracture or dislocations.
Soft Tissues: No space-occupying masses.
Vessels: Normal neurovascular bundle.
Impressions
1.Avulsion and high-grade strain of the foveal and ulnar attachments, respectively of the proximal and distal band of the triangular ligament with diffuse edema throughout the meniscus homologous in keeping with a Palmer type 1B injury of the TFCC.
2.Low-grade strain of the dorsal radioulnar ligament.
Case Discussion
Faculty
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
ProScan Imaging
Jenny T Bencardino, MD
Vice-Chair, Academic Affairs Department of Radiology
Montefiore Radiology
Todd D. Greenberg, MD
Radiologist
ProScan
Tags
Musculoskeletal (MSK)
MRI
Hand & Wrist
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