Tenderness between the pisiform and ulnar stiloid on the ulnarborder of the wrist
Distal radio ulnar joint instability (piano key sign)
Diagnosis: imaging studies
Tricompartiment Wrist arthrogram
MRI arthrogram (high resolution)
CT scan in neutral and pronation and supination
Wrist arthroscopy
Diagnosis: arthroscopy
Advantage
- Diagnostic
- Therapeutic
Diagnosis and Treatement
The physician treating high level athletes may consider a more aggressiv approach to the patient with suspected TFC/DRUJ injury
If DRUJ intability is demonstrated, early intervention with arthroscopy (TFC repair)
If DRUJ is stable and symtoms are present for 2 weeks, arthroscopy is indicated
TFC injuries acute: Arthroscopic diagnosis
CLASSIFICATION OF TFCC TEARS (Palmer)
1A ( traumatic tears of the central articular disc)
1B (peripheral TFC at the ulnar insertion)
1C (distal to ulnolunate-ulnotriquetral lig.)
1D (lesion at the radial insertion)
Palmer 1A
Treatment: arthroscopic debridement
Palmer 1B
Treatment: artroscopic repair
Palmer 1C
Treatment: repair of ulnocarpal ligaments open or arthroscopicaly
TFC
Diagnosis: physical examination 
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