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Extrinsic Ligament Injury, Wrist
Sarah Stilwill, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Extrinsic ligaments connect distal forearm bones to carpal bones and provide gross stability
              • Radioscaphocapitate (vRSC), radiolunotriquetral [(vRLT), a.k.a. long radiolunate], and short radiolunate (vRL): 3 most important volar extrinsic ligaments
                • vRSC: Provides supporting sling for scaphoid and prevents rotatory subluxation
                • vRLT: Largest volar ligament and important for maintaining stability of proximal carpal row in combination with vRSC
                • vRL: Critical stabilizer of lunate and prevents lunate hyperextension (dorsal tilt)
              • Dorsal extrinsic ligaments converge on triquetrum and are implicated in dorsal wrist sprain injuries
                • Radiotriquetral [(dRT), a.k.a. radiolunotriquetral]
                  • Largest dorsal ligament, extending from Lister's tubercle to dorsal triquetrum
                • dRT and intrinsic dorsal intercarpal ligament (DIC) implicated in dorsal wrist sprain injuries
                • DIC: Intrinsic capsular ligament, aiding in dorsal capsular stabilization
                  • Attaches on triquetrum with variant fiber attachments to scaphoid, trapezoid, and trapezium

            IMAGING

            • General Features

              • Radiographic Findings

                • MR Findings

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      CLINICAL ISSUES

                      • Presentation

                        • Treatment

                          DIAGNOSTIC CHECKLIST

                          • Consider

                            Selected References

                            1. Mak WH et al: Assessment of volar radiocarpal ligaments: MR arthrographic and arthroscopic correlation. AJR Am J Roentgenol. 198(2):423-7, 2012
                            2. Davis KW et al: Imaging the ligaments and tendons of the wrist. Semin Roentgenol. 45(3):194-217, 2010
                            3. Theumann NH et al: Extrinsic carpal ligaments: normal MR arthrographic appearance in cadavers. Radiology. 226(1):171-9, 2003
                            4. Berger RA: The anatomy and basic biomechanics of the wrist joint. J Hand Ther. 9(2):84-93, 1996
                            Related Anatomy
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                            Related Differential Diagnoses
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                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Terminology

                              • Imaging

                                • Pathology

                                  • Clinical Issues

                                    • Diagnostic Checklist

                                      TERMINOLOGY

                                      • Definitions

                                        • Extrinsic ligaments connect distal forearm bones to carpal bones and provide gross stability
                                        • Radioscaphocapitate (vRSC), radiolunotriquetral [(vRLT), a.k.a. long radiolunate], and short radiolunate (vRL): 3 most important volar extrinsic ligaments
                                          • vRSC: Provides supporting sling for scaphoid and prevents rotatory subluxation
                                          • vRLT: Largest volar ligament and important for maintaining stability of proximal carpal row in combination with vRSC
                                          • vRL: Critical stabilizer of lunate and prevents lunate hyperextension (dorsal tilt)
                                        • Dorsal extrinsic ligaments converge on triquetrum and are implicated in dorsal wrist sprain injuries
                                          • Radiotriquetral [(dRT), a.k.a. radiolunotriquetral]
                                            • Largest dorsal ligament, extending from Lister's tubercle to dorsal triquetrum
                                          • dRT and intrinsic dorsal intercarpal ligament (DIC) implicated in dorsal wrist sprain injuries
                                          • DIC: Intrinsic capsular ligament, aiding in dorsal capsular stabilization
                                            • Attaches on triquetrum with variant fiber attachments to scaphoid, trapezoid, and trapezium

                                      IMAGING

                                      • General Features

                                        • Radiographic Findings

                                          • MR Findings

                                            DIFFERENTIAL DIAGNOSIS

                                              PATHOLOGY

                                              • General Features

                                                CLINICAL ISSUES

                                                • Presentation

                                                  • Treatment

                                                    DIAGNOSTIC CHECKLIST

                                                    • Consider

                                                      Selected References

                                                      1. Mak WH et al: Assessment of volar radiocarpal ligaments: MR arthrographic and arthroscopic correlation. AJR Am J Roentgenol. 198(2):423-7, 2012
                                                      2. Davis KW et al: Imaging the ligaments and tendons of the wrist. Semin Roentgenol. 45(3):194-217, 2010
                                                      3. Theumann NH et al: Extrinsic carpal ligaments: normal MR arthrographic appearance in cadavers. Radiology. 226(1):171-9, 2003
                                                      4. Berger RA: The anatomy and basic biomechanics of the wrist joint. J Hand Ther. 9(2):84-93, 1996