Expert opinion of triangular fibrocartilage complex lesions

An expert opinion on triangular fibrocartilage complex (TFCC) must differentiate between normal variants and damage from wear and tear. Magnetic resonance tomography, and in particular arthroscopy, can help in diagnosis, while classification of damage is possible. Crucial to any expert opinion is an appraisal of the mode of accident, e.g. compression trauma as a result of falling on the supporting hand or non-physiological tensile or compressive stress due to poor positioning on lower arm extremities distant from the body. Generally, however, disc injury occurs in association with distal radius fractures and hypersupination trauma with laceration of the radioulnar ligament. The differential diagnosis of disc damage (both injury and wear and tear) includes meniscus damage and pathomorphologic changes due to an existing central disc defect. Following verification of the mode of accident, the diagnosis of disc injury is established; its effects must be differentiated from the actual lesion.