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Wrist ligaments
Intrinsic
• Inter connect
individual carpal
bones
Extrinsic
• link the carpal
bones to the
radius, ulna,
and metacarpal
bones.
• Three V-shaped groups:
–two on the volar side and
–one on the dorsal side
Intrinsic lig.
• ScaphoLunate lig (SLL)
• LunoTriquetral lig (LTL)
• ScaphoTrapezioTrapezoid
(STT)
Dorsal Extrinsic lig.
• Dorsal RadioTriquetral
• Dorsal RadioUlnar
TFCC
Volar Extrinsic lig.
• Volar RadioScaphoCapitate
• Volar RadioLunoTriquetral
• Volar Ulnolunate
• Volar UlnoTriquetral
• Volar RadioUlnar
Thumb lig
• Supf. Ant. Oblique lig
• Deep Ant. Oblique lig
• DorsoRadial lig
Intrinsic lig.
• ScaphoLunate lig (SLL)
• LunoTriquetral lig (LTL)
• ScaphoTrapezioTrapezoid
(STT)
Dorsal Extrinsic lig.
• Dorsal RadioTriquetral
• Dorsal RadioUlnar
TFCC
Volar Extrinsic lig.
• Volar RadioScaphoCapitate
• Volar RadioLunoTriquetral
• Volar Ulnolunate
• Volar UlnoTriquetral
• Volar RadioUlnar
Thumb lig
• Supf. Ant. Oblique lig
• Deep Ant. Oblique lig
• DorsoRadial lig
TFCC (Triangular fibrocartialge complex)
• Volar Ulnolunate
• Volar UlnoTriquetral
• Volar RadioUlnar
• Dorsal RadioUlnar
• Triangular Fibro cartilage
• Meniscal Homologue
• Ulnar Collateral ligament
• Extensor Carpi Ulnaris Tendon sheath
Intrinsic lig.
• ScaphoLunate lig (SLL)
• LunoTriquetral lig (LTL)
• ScaphoTrapezioTrapezoid
(STT)
Dorsal Extrinsic lig.
• Dorsal RadioTriquetral
• Dorsal RadioUlnar
TFCC
Volar Extrinsic lig.
• Volar RadioScaphoCapitate
• Volar RadioLunoTriquetral
• Volar Ulnolunate
• Volar UlnoTriquetral
• Volar RadioUlnar
Thumb lig
• Supf. Ant. Oblique lig
• Deep Ant. Oblique lig
• DorsoRadial lig
Intrinsic ligaments
ScaphoLunate lig (SLL)
Intrinsic ligaments
ScaphoLunate lig (SLL)
Intrinsic ligaments
ScaphoLunate lig (SLL)
Intrinsic ligaments
ScaphoLunate lig (SLL)
Partial tear
Intrinsic lig.
• ScaphoLunate lig (SLL)
• LunoTriquetral lig (LTL)
• ScaphoTrapezioTrapezoid
(STT)
Dorsal Extrinsic lig.
• Dorsal RadioTriquetral
• Dorsal RadioUlnar
TFCC
Volar Extrinsic lig.
• Volar RadioScaphoCapitate
• Volar RadioLunoTriquetral
• Volar Ulnolunate
• Volar UlnoTriquetral
• Volar RadioUlnar
Thumb lig
• Supf. Ant. Oblique lig
• Deep Ant. Oblique lig
• DorsoRadial lig
Intrinsic ligaments
LunoTriquetral lig (LTL)
Intrinsic ligaments
LunoTriquetral lig (LTL)
Partial tear
Gradient echo MR
Intrinsic lig.
• ScaphoLunate lig (SLL)
• LunoTriquetral lig (LTL)
• ScaphoTrapezioTrapezoid
(STT)
Dorsal Extrinsic lig.
• Dorsal RadioTriquetral
• Dorsal RadioUlnar
TFCC
Volar Extrinsic lig.
• Volar RadioScaphoCapitate
• Volar RadioLunoTriquetral
• Volar Ulnolunate
• Volar UlnoTriquetral
• Volar RadioUlnar
Thumb lig
• Supf. Ant. Oblique lig
• Deep Ant. Oblique lig
• DorsoRadial lig
Intrinsic ligaments
ScaphoTrapezioTrapezoid (STT)
Intrinsic ligaments
ScaphoTrapezioTrapezoid (STT)
Other Intrinsic ligaments
Dorsal Inter Carpal (DIC)
Other Intrinsic ligaments
ScaphoCapitate lig.
Other Intrinsic ligaments
TriquetroCapitate lig.
Deltoid lig.
Other Intrinsic ligaments
TriquetroCapitate lig.
ScaphoCapitate lig.
Deltoid lig.
Other Intrinsic ligaments
TriquetroHamate lig.
Intrinsic lig.
• ScaphoLunate lig (SLL)
• LunoTriquetral lig (LTL)
• ScaphoTrapezioTrapezoid
(STT)
Dorsal Extrinsic lig.
• Dorsal RadioTriquetral
• Dorsal RadioUlnar
TFCC
Volar Extrinsic lig.
• Volar RadioScaphoCapitate
• Volar RadioLunoTriquetral
• Volar Ulnolunate
• Volar UlnoTriquetral
• Volar RadioUlnar
Thumb lig
• Supf. Ant. Oblique lig
• Deep Ant. Oblique lig
• DorsoRadial lig
Volar Extrinsic ligaments
Volar RadioScaphoCapitate
Volar Extrinsic ligaments
Volar RadioScaphoCapitate
1
Volar Extrinsic ligaments
Volar RadioScaphoCapitate
Volar Extrinsic ligaments
Volar RadioScaphoCapitate
Intrinsic lig.
• ScaphoLunate lig (SLL)
• LunoTriquetral lig (LTL)
• ScaphoTrapezioTrapezoid
(STT)
Dorsal Extrinsic lig.
• Dorsal RadioTriquetral
• Dorsal RadioUlnar
TFCC
Volar Extrinsic lig.
• Volar RadioScaphoCapitate
• Volar RadioLunoTriquetral
• Volar Ulnolunate
• Volar UlnoTriquetral
• Volar RadioUlnar
Thumb lig
• Supf. Ant. Oblique lig
• Deep Ant. Oblique lig
• DorsoRadial lig
Volar Extrinsic ligaments
Volar RadioLunoTriquetral
Volar Extrinsic ligaments
Volar RadioLunoTriquetral
Volar Extrinsic ligaments
Volar RadioLunoTriquetral
Volar Extrinsic ligaments
Volar RadioLunoTriquetral
Intrinsic lig.
• ScaphoLunate lig (SLL)
• LunoTriquetral lig (LTL)
• ScaphoTrapezioTrapezoid
(STT)
Dorsal Extrinsic lig.
• Dorsal RadioTriquetral
• Dorsal RadioUlnar
TFCC
Volar Extrinsic lig.
• Volar RadioScaphoCapitate
• Volar RadioLunoTriquetral
• Volar Ulnolunate
• Volar UlnoTriquetral
• Volar RadioUlnar
Thumb lig
• Supf. Ant. Oblique lig
• Deep Ant. Oblique lig
• DorsoRadial lig
Dorsal Extrinsic ligaments
Dorsal RadioTriquetral
Intrinsic lig.
• ScaphoLunate lig (SLL)
• LunoTriquetral lig (LTL)
• ScaphoTrapezioTrapezoid
(STT)
Dorsal Extrinsic lig.
• Dorsal RadioTriquetral
• Dorsal RadioUlnar
TFCC
Volar Extrinsic lig.
• Volar RadioScaphoCapitate
• Volar RadioLunoTriquetral
• Volar Ulnolunate
• Volar UlnoTriquetral
• Volar RadioUlnar
Thumb lig
• DorsoRadial lig
• Supf. Ant. Oblique lig
• Deep Ant. Oblique lig
Ligaments of the Thumb
DorsoRadial lig
Intrinsic lig.
• ScaphoLunate lig (SLL)
• LunoTriquetral lig (LTL)
• ScaphoTrapezioTrapezoid
(STT)
Dorsal Extrinsic lig.
• Dorsal RadioTriquetral
• Dorsal RadioUlnar
TFCC
Volar Extrinsic lig.
• Volar RadioScaphoCapitate
• Volar RadioLunoTriquetral
• Volar Ulnolunate
• Volar UlnoTriquetral
• Volar RadioUlnar
Thumb lig
• DorsoRadial lig
• Supf. Ant. Oblique lig
• Deep Ant. Oblique lig
Ligaments of the Thumb
Supf. & Deep Ant. Oblique lig
TFCC (Triangular fibrocartialge complex)
• Triangular Fibro cartilage
• Volar RadioUlnar
• Dorsal RadioUlnar
• Volar Ulnolunate
• Volar UlnoTriquetral
• Meniscal Homologue
• Ulnar Collateral ligament
• Extensor Carpi Ulnaris Tendon sheath
TFCC (Triangular fibrocartialge complex)
• Triangular Fibro cartilage
• Volar RadioUlnar lig.
• Dorsal RadioUlnar lig.
• Volar Ulnolunate lig.
• Volar UlnoTriquetral
• Meniscal Homologue
• Ulnar Collateral ligament
• Extensor Carpi Ulnaris Tendon sheath
TFCC
Triangular Fibro cartilage
TFCC
Triangular Fibro cartilage
TFCC
Triangular Fibro cartilage
TFCC
Triangular Fibro cartilage
5
TFCC
Triangular Fibro cartilage
5
TFCC
Triangular Fibro cartilage
Partial tear Complete tear
TFCC
Triangular Fibro cartilage
TFCC
Triangular Fibro cartilage
TFCC
Triangular Fibro cartilage
Central perforation
TFCC
Triangular Fibro cartilage
Tear vs Central perforation
TFCC (Triangular fibrocartialge complex)
• Triangular Fibro cartilage
• Volar RadioUlnar lig.
• Dorsal RadioUlnar lig.
• Volar Ulnolunate lig.
• Volar UlnoTriquetral lig.
• Meniscal Homologue
• Ulnar Collateral ligament
• Extensor Carpi Ulnaris Tendon sheath
TFCC
Volar & Dorsal RadioUlnar lig.
TFCC
Volar & Dorsal RadioUlnar lig.
TFCC
Volar & Dorsal RadioUlnar lig.
TFCC
Volar & Dorsal RadioUlnar lig.
TFCC
Volar & Dorsal RadioUlnar lig.
TFCC (Triangular fibrocartialge complex)
• Triangular Fibro cartilage
• Volar RadioUlnar lig.
• Dorsal RadioUlnar lig.
• Volar Ulnolunate lig.
• Volar UlnoTriquetral lig.
• Meniscal Homologue
• Ulnar Collateral ligament
• Extensor Carpi Ulnaris Tendon sheath
TFCC
Volar Ulnolunate & UlnoTriquetral lig.
TFCC
Volar Ulnolunate & UlnoTriquetral lig.
TFCC
Volar Ulnolunate & UlnoTriquetral lig.
TFCC (Triangular fibrocartialge complex)
• Triangular Fibro cartilage
• Volar RadioUlnar lig.
• Dorsal RadioUlnar lig.
• Volar Ulnolunate lig.
• Volar UlnoTriquetral lig.
• Meniscal Homologue
• Ulnar Collateral ligament
• Extensor Carpi Ulnaris Tendon sheath
TFCC
Meniscal Homologue
TFCC
Meniscal Homologue
TFCC
Meniscal Homologue
TFCC (Triangular fibrocartialge complex)
• Triangular Fibro cartilage
• Volar RadioUlnar lig.
• Dorsal RadioUlnar lig.
• Volar Ulnolunate lig.
• Volar UlnoTriquetral lig.
• Meniscal Homologue
• Ulnar Collateral ligament
• Extensor Carpi Ulnaris Tendon sheath
TFCC
Ulnar Collateral ligament
TFCC
Ulnar Collateral ligament
TFCC
Ulnar Collateral ligament
TFCC (Triangular fibrocartialge complex)
• Triangular Fibro cartilage
• Volar RadioUlnar lig.
• Dorsal RadioUlnar lig.
• Volar Ulnolunate lig.
• Volar UlnoTriquetral lig.
• Meniscal Homologue
• Ulnar Collateral ligament
• Extensor Carpi Ulnaris Tendon sheath
TFCC
Extensor Carpi Ulnaris Tendon sheath
TFCC
Extensor Carpi Ulnaris Tendon sheath
TFCC
Extensor Carpi Ulnaris Tendon sheath
TFCC
TFCC
TFCC
Palmer classification
Type 1A
- Central TFC perforation
Type 1B
- Peripheral ulnar side
TFCC tear (+/- ulnar styloid
fracture)
Type 1C
- Distal TFCC disruption
(Disruption from distal UC
lig.)
Type 1D
- Radial TFCC disruption
TFCC
Type 1A - Central TFC perforation
TFCC
Type 1B
- Peripheral ulnar side TFCC tear (+/- ulnar styloid fracture)
TFCC
Type 1A - Central TFC perforation
TFCC
Type 1B
- Peripheral ulnar side TFCC tear (+/- ulnar styloid fracture)
TFCC
Type 1D - Radial TFCC disruption
TFCC
Palmer classification
Type 2A
- TFCC wear
Type 2B
- TFCC wear with Lunate
and/or Ulnar chondro-
malacia
Type 2C
- TFCC perforation with
Lunate and/or Ulnar
chondromalacia
Type 2D
- 2C + LTIOL perforation
Type 2E
- 2D + Ulnocarpal
arthritis
Wrist ligaments

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Wrist ligaments

Notas do Editor

  1. 8, 14, 13, 12 ligaments respectively
  2. The capitate bone is at the apex of the more distal V-shaped complex of fibers that originates proximally and laterally from the radius and scaphoid (includes the extrinsic radioscaphocapitate ligament and the intrinsic scaphocapitate ligament) and proximally and medially from the triquetrum (includes the intrinsic triquetrocapitate ligament and blends with the intninsic triquetrohamate ligament). more proximal V-shaped group made up of the radiolunotriquetral ligament and portions of the ulnocarpal complex.
  3. The dorsal ligaments of importance are the dorsal radiotriquetral and dorsal intercarpal (intrinsic) ligaments, which form a tnansvensely oriented V shape that extends from the dorsal aspect of the distal radius near the Listen tubercle to the tniquetrum, then back to the dorsal scaphoid rim (3) (Fig 9). The apex of the V points toward the ulnar side.
  4. Fat sat T2
  5. PD
  6. T1W MR Arthrogram
  7. 1
  8. T1W MR Arthrogram
  9. PD
  10. T1W MR Arthrogram
  11. T1W MR Arthrogram
  12. PD
  13. PD
  14. T1 arthrogram
  15. T1 arthrogram
  16. T1 arthrogram
  17. 1-RadioScaphoCapitate, 2-RadioTriquetral, 6-Ulnotriquetral, 5-TFC
  18. 1-RadioScaphoCapitate, 2-RadioTriquetral, 6-Ulnotriquetral, 5-TFC
  19. 1-RadioScaphoCapitate, 2-RadioTriquetral, 6-Ulnotriquetral, 5-TFC
  20. Non viaualisation of ulnar attachment of dorsal RUL s/o tear
  21. Non viaualisation of ulnar attachment of dorsal RUL s/o tear
  22. Non viaualisation of ulnar attachment of dorsal RUL s/o tear
  23. T = triquetrum, L = lunatum, H = hamatum, R = radius, U = ulna, 1 = ECU tendon and sheath, 2 = ulnar carpal collateral ligament,  3= ulnomeniscal homologue (UMH), 4 = triangular fibrocartilage complex (TFCC), Arrow = prestyloid recess.
  24. T = triquetrum, L = lunatum, H = hamatum, R = radius, U = ulna, 1 = ECU tendon and sheath, 2 = ulnar carpal collateral ligament,  3= ulnomeniscal homologue (UMH), 4 = triangular fibrocartilage complex (TFCC), Arrow = prestyloid recess.
  25. T = triquetrum, L = lunatum, H = hamatum, R = radius, U = ulna, 1 = ECU tendon and sheath, 2 = ulnar carpal collateral ligament,  3= ulnomeniscal homologue (UMH), 4 = triangular fibrocartilage complex (TFCC), Arrow = prestyloid recess.
  26. T = triquetrum, L = lunatum, H = hamatum, R = radius, U = ulna, 1 = ECU tendon and sheath, 2 = ulnar carpal collateral ligament,  3= ulnomeniscal homologue (UMH), 4 = triangular fibrocartilage complex (TFCC), Arrow = prestyloid recess.
  27. T = triquetrum, L = lunatum, H = hamatum, R = radius, U = ulna, 1 = ECU tendon and sheath, 2 = ulnar carpal collateral ligament,  3= ulnomeniscal homologue (UMH), 4 = triangular fibrocartilage complex (TFCC), Arrow = prestyloid recess.
  28. T = triquetrum, L = lunatum, H = hamatum, R = radius, U = ulna, 1 = ECU tendon and sheath, 2 = ulnar carpal collateral ligament,  3= ulnomeniscal homologue (UMH), 4 = triangular fibrocartilage complex (TFCC), Arrow = prestyloid recess.
  29. T = triquetrum, L = lunatum, H = hamatum, R = radius, U = ulna, 1 = ECU tendon and sheath, 2 = ulnar carpal collateral ligament,  3= ulnomeniscal homologue (UMH), 4 = triangular fibrocartilage complex (TFCC), Arrow = prestyloid recess.
  30. T = triquetrum, L = lunatum, H = hamatum, R = radius, U = ulna, 1 = ECU tendon and sheath, 2 = ulnar carpal collateral ligament,  3= ulnomeniscal homologue (UMH), 4 = triangular fibrocartilage complex (TFCC), Arrow = prestyloid recess.
  31. T = triquetrum, L = lunatum, H = hamatum, R = radius, U = ulna, 1 = ECU tendon and sheath, 2 = ulnar carpal collateral ligament,  3= ulnomeniscal homologue (UMH), 4 = triangular fibrocartilage complex (TFCC), Arrow = prestyloid recess.
  32. T = triquetrum, L = lunatum, H = hamatum, R = radius, U = ulna, 1 = ECU tendon and sheath, 2 = ulnar carpal collateral ligament,  3= ulnomeniscal homologue (UMH), 4 = triangular fibrocartilage complex (TFCC), Arrow = prestyloid recess.
  33. T = triquetrum, L = lunatum, H = hamatum, R = radius, U = ulna, 1 = ECU tendon and sheath, 2 = ulnar carpal collateral ligament,  3= ulnomeniscal homologue (UMH), 4 = triangular fibrocartilage complex (TFCC), Arrow = prestyloid recess.