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Intrinsic Ligament Tear, Wrist
Carol L. Andrews, MD; Donna G. Blankenbaker, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Synonyms

            • Terry Thomas sign (David Letterman sign, Lauren Hutton sign): Scapholunate ligament disruption with interspace widening; mimics space between front teeth
          • Definitions

            • Intrinsic ligaments: Ligaments connecting 1 carpal bone to another
            • Extrinsic ligaments: Capsular thickenings connecting carpals to metacarpals, radius, or ulna
            • Intercarpal ligament disruption
              • Most commonly relates to scapholunate ligament (SLL) and lunotriquetral ligament (LTL)

          IMAGING

          • General Features

            • Radiographic Findings

              • Fluoroscopic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Imaging Recommendations

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Lee RK et al: Intrinsic ligament and triangular fibrocartilage complex tears of the wrist: comparison of MDCT arthrography, conventional 3-T MRI, and MR arthrography. Skeletal Radiol. 42(9):1277-85, 2013
                                        2. Taljanovic MS et al: US of the intrinsic and extrinsic wrist ligaments and triangular fibrocartilage complex--normal anatomy and imaging technique. Radiographics. 31(1):e44, 2011
                                        3. De Filippo M et al: MDCT arthrography of the wrist: diagnostic accuracy and indications. Eur J Radiol. 74(1):221-5, 2010
                                        4. Gheno R et al: Differences between radial and ulnar deviation of the wrist in the study of the intrinsic intercarpal ligaments: magnetic resonance imaging and gross anatomic inspection in cadavers. Skeletal Radiol. Epub ahead of print, 2009
                                        5. Watanabe A et al: Ulnar-sided wrist pain. II. Clinical imaging and treatment. Skeletal Radiol. 39(9):837-57, 2010
                                        6. Lisle DA et al: MR imaging of traumatic and overuse injuries of the wrist and hand in athletes. Magn Reson Imaging Clin N Am. 17(4):639-54, vi, 2009
                                        7. Moser T et al: Multidetector CT arthrography of the wrist joint: how to do it. Radiographics. 28(3):787-800; quiz 911, 2008
                                        8. Rettig AC: Athletic injuries of the wrist and hand: part II: overuse injuries of the wrist and traumatic injuries to the hand. Am J Sports Med. 32(1):262-73, 2004
                                        9. Haims AH et al: Internal derangement of the wrist: indirect MR arthrography versus unenhanced MR imaging. Radiology. 227(3):701-7, 2003
                                        10. Linkous MD et al: Scapholunate ligamentous communicating defects in symptomatic and asymptomatic wrists: characteristics. Radiology. 216(3):846-50, 2000
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Synonyms

                                                  • Terry Thomas sign (David Letterman sign, Lauren Hutton sign): Scapholunate ligament disruption with interspace widening; mimics space between front teeth
                                                • Definitions

                                                  • Intrinsic ligaments: Ligaments connecting 1 carpal bone to another
                                                  • Extrinsic ligaments: Capsular thickenings connecting carpals to metacarpals, radius, or ulna
                                                  • Intercarpal ligament disruption
                                                    • Most commonly relates to scapholunate ligament (SLL) and lunotriquetral ligament (LTL)

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • Fluoroscopic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Imaging Recommendations

                                                              PATHOLOGY

                                                              • General Features

                                                                • Staging, Grading, & Classification

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Lee RK et al: Intrinsic ligament and triangular fibrocartilage complex tears of the wrist: comparison of MDCT arthrography, conventional 3-T MRI, and MR arthrography. Skeletal Radiol. 42(9):1277-85, 2013
                                                                              2. Taljanovic MS et al: US of the intrinsic and extrinsic wrist ligaments and triangular fibrocartilage complex--normal anatomy and imaging technique. Radiographics. 31(1):e44, 2011
                                                                              3. De Filippo M et al: MDCT arthrography of the wrist: diagnostic accuracy and indications. Eur J Radiol. 74(1):221-5, 2010
                                                                              4. Gheno R et al: Differences between radial and ulnar deviation of the wrist in the study of the intrinsic intercarpal ligaments: magnetic resonance imaging and gross anatomic inspection in cadavers. Skeletal Radiol. Epub ahead of print, 2009
                                                                              5. Watanabe A et al: Ulnar-sided wrist pain. II. Clinical imaging and treatment. Skeletal Radiol. 39(9):837-57, 2010
                                                                              6. Lisle DA et al: MR imaging of traumatic and overuse injuries of the wrist and hand in athletes. Magn Reson Imaging Clin N Am. 17(4):639-54, vi, 2009
                                                                              7. Moser T et al: Multidetector CT arthrography of the wrist joint: how to do it. Radiographics. 28(3):787-800; quiz 911, 2008
                                                                              8. Rettig AC: Athletic injuries of the wrist and hand: part II: overuse injuries of the wrist and traumatic injuries to the hand. Am J Sports Med. 32(1):262-73, 2004
                                                                              9. Haims AH et al: Internal derangement of the wrist: indirect MR arthrography versus unenhanced MR imaging. Radiology. 227(3):701-7, 2003
                                                                              10. Linkous MD et al: Scapholunate ligamentous communicating defects in symptomatic and asymptomatic wrists: characteristics. Radiology. 216(3):846-50, 2000