Triangular Fibrocartilage Complex Tears

The wrist is a complex joint made up of small bones, cartilage, and stabilizing ligaments, including the triangular fibrocartilage complex (TFCC) and intrinsic carpal ligaments. Because these structures are small and intricate, diagnosing internal joint damage (internal derangement) after trauma or chronic pain can be challenging. Magnetic resonance arthrography (MRA), an imaging scan performed after injecting a contrast dye into the joint, is widely used because it shows soft tissues clearly. However, MRA can sometimes miss subtle bone fragments, cartilage defects, or partial ligament tears due to lower spatial resolution. Computed tomography arthrography (CTA) provides higher-detail spatial imaging and excels at identifying small bone injuries and ligament tears, though it offers less soft-tissue contrast than MRI. The purpose of this study is to determine whether performing CT arthrography in addition to MR arthrography improves the detection and characterization of internal wrist pathologies compared with MR arthrography alone. Participants enrolled in this study will: * Undergo a clinical history taking and examination regarding their wrist symptoms. * Receive an ultrasound-guided injection into the radiocarpal joint using a sterile mixture containing iodinated contrast, gadolinium contrast, saline, and a local numbing medication (xylocaine). * Undergo a high-resolution CT scan of the wrist immediately following the injection. * Undergo a 1.5T MR arthrography scan. Researchers will compare the findings between the two imaging techniques to evaluate how often adding CT arthrography identifies additional lesions that were occult or inconclusive on MR arthrography.

The Triangular fibrocartilage complex (TFCC) is a grouping of ligaments and cartilage in the wrist The TFCC is comprised of six major components: the distal radioulnar ligaments (dorsal and volar), central articular disk, meniscus homolog, ulnar collateral ligament, ECU subsheath, and the ulnolunate (UL)/ulnotriquetral (UT) ligaments. This is important for wrist motion, stabilization, and overall hand function, including grip strength may progress to persistent pain, instability of the distal radioulnar joint, and arthritis if left untreated.. The TFCC vascularity is supplied by the anterior interosseous and ulnar arteries, although only a quarter of the TFCC is perfused. The limited vascularity of the TFCC, combined with its intricate soft tissue structure and torsional and axial stresses, makes the TFCC prone to frequent injury while maintaining a limited ability to heal. Injuries like a fall on the outstretched hand or a forced ulnar deviation of the wrist can lead to an acute TFCC tear. TFCC tears are a common cause of ulnar sided wrist pain and can be caused by chronic degeneration or traumatic injury. Acute or chronic triangular fibrocartilage complex (TFCC) tears may result in persistent ulnar-sided wrist pain, loss of grip strength, and loss of function for patients. A combination of clinical history, physical examination, and magnetic resonance imaging (MRI) may be used to diagnose a TFCC lesion, but confirmation of pathology requires an arthroscopic assessment. Arthroscopic assisted repair techniques have revolutionized surgical management Treatment of TFCC using mini anchor arthroscopically providing many benefits. Functional outcome using Mayo wrist score after arthroscopic repair of triangular fibrocartilage complex tears using mini anchor