What is Prestyloid recess?
The prestyloid recess is a synovium-lined pouch with direct connection to the rest of the radiocarpal compartment. It is most commonly a saccular space bordered by the meniscal homologue distally, the TFCC attachments to the ulnar styloid process proximally, and the central TFCC disk radially (Fig 12) (20).
What is meniscal homologue?
The meniscal homologue is displayed as an echogenic structure adjacent to the triangular fibrocartilage disc, deep to the overlying ulnar collateral ligament of the wrist and the extensor carpi ulnaris tendon 3.
What structures make up the TFCC?
The Triangular Fibrocartilage Complex is the ligamentous and cartilaginous structures that separate the radiocarpal from the distal radioulnar joint. The TFCC consists of an articular disc, meniscus homologue, ulnocarpal ligament, dorsal & volar radioulnar ligament and extensor carpi ulnaris sheath.
What is ulnar variance?
Ulnar variance (also known as Hulten variance) refers to the relative lengths of the distal articular surfaces of the radius and ulna. Ulnar variance may be: neutral (both the ulnar and radial articular surfaces at the same level) positive (ulna projects more distally) negative (ulna projects more proximally)
What is a TFCC sprain?
A triangular fibrocartilage complex (TFCC) tear or sprain occurs when the triangular fibrocartilage complex (TFCC), a cartilage structure that joins the end of the forearm to the small wrist bones on the pinkie side, is strained due to an injury or a golf swing.
What causes ulnar variance?
The most common predisposing factor is positive ulnar variance, an increased ulnar length relative to the radius. In the positive ulnar variance wrist, the TFCC is stretched and thin, and greater biomechanical forces, specially rotation forces, impact the joint.
How common is ulnar variance?
The median ulnar variance was 0.65 (−4.8–5.7, range: 10.5) for all 600 wrists.
How serious is TFCC?
The TFCC stabilizes and cushions the wrist, particularly when a person rotates their hand or grasps something with it. Due to its structural complexity, the TFCC is vulnerable to damage, and injuries are common. In this article, we discuss the symptoms, causes, diagnosis, and treatment of TFCC tears.
Where is the prestyloid recess in the wrist?
MRI of wrist reveals a sharply demarcated cystic lesion splaying the ulnocarpal meniscal homologue within the prestyloid recess, between the ulnotriquetral ligament and ulnar capsule. The adjacent pisimetacarpal ligament is thickened. Marrow edema is seen suggesting reactionary osteitis at pisiform.
When does the UMH and the prestyloid recess appear?
Assessment of the UMH and the prestyloid recess is only possible in the presence of effusion or intra-articular contrast (MR-arthrography). The appearance of this recess is highly dependent on the wrist position at imaging: if present, it collapses on ulnar abduction.
Where is the prestyloid recess in the TFCC?
The prestyloid recess was observed between the DP and MH. The ulnar collateral ligament (UCL) existed at the ulnar side of the TFCC and consisted of the sheath floor of the extensor carpi ulnaris (ECU) with relatively loose ligamentous tissue recognized as 6U-portal in arthroscopy.
What are the symptoms of prestyloid recess synovitis?
The adjacent pisimetacarpal ligament is thickened. Marrow edema is seen suggesting reactionary osteitis at pisiform. Acute prestyloid synovitis/ bursitis with ganglion cyst formation. Barakat MS, Schweitzer ME, Morisson WB et-al. Reactive carpal synovitis: initial experience with MR imaging.
