MRI Arthrogram Wrist: R/O TFCC, SL or LT Ligament Tear

A patient presented with ulnar-sided wrist pain after a fall while roller skating. In order to ensure that contrast was injected precisely into the cleft, fluoroscopy was used, as shown in the first image. The needle is circled.

Below: An MRI showed that contrast had not flowed into the cleft. Therefore, the MRI was normal. The lower circle is of the triangular fibrocartilage complex (TFCC). The upper right circle is of the scapholunate ligament, while the top left circle is the lunatotriquetral ligament. An MRI with injected contrast would be used to diagnose a possible tear in any of the three locations and should be ordered as an MRI arthrogram or, if MRI is contraindicated, a CT arthrogram; not as an "MRI or CT with contrast."

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