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BioMed Research International
Volume 2017, Article ID 5870875, 7 pages
https://doi.org/10.1155/2017/5870875
Research Article

Can the Diagnostics of Triangular Fibrocartilage Complex Lesions Be Improved by MRI-Based Soft-Tissue Reconstruction? An Imaging-Based Workup and Case Presentation

1Department of Anatomy, University of Otago, Dunedin, New Zealand
2Department of Anatomy, University of Leipzig, Leipzig, Germany
3Department of Orthopedic and Trauma Surgery, University Clinics of Leipzig, Leipzig, Germany
4Fraunhofer Institute for Machine Tools and Forming Technology (IWU), Dresden, Germany

Correspondence should be addressed to Niels Hammer; moc.liamelgoog@remmahsln

Received 17 October 2016; Revised 2 December 2016; Accepted 4 January 2017; Published 29 January 2017

Academic Editor: Enzo Terreno

Copyright © 2017 Niels Hammer et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. The triangular fibrocartilage complex (TFCC) provides both mobility and stability of the radiocarpal joint. TFCC lesions are difficult to diagnose due to the complex anatomy. The standard treatment for TFCC lesions is arthroscopy, posing surgery-related risks onto the patients. This feasibility study aimed at developing a workup for soft-tissue reconstruction using clinical imaging, to verify these results in retrospective patient data. Methods. Microcomputed tomography (μ-CT), 3 T magnetic resonance imaging (MRI), and plastination were used to visualize the TFCC in cadaveric specimens applying segmentation-based 3D reconstruction. This approach further trialed the MRI dataset of a patient with minor radiological TFCC alterations but persistent pain. Results. TFCC reconstruction was impossible using μ-CT only but feasible using MRI, resulting in an appreciation of its substructures, as seen in the plastinates. Applying this approach allowed for visualizing a Palmer 2C lesion in a patient, confirming ex postum the arthroscopy findings, being markedly different from MRI (Palmer 1B). Discussion. This preliminary study showed that image-based TFCC reconstruction may help to identify pathologies invisible in standard MRI. The combined approach of μ-CT, MRI, and plastination allowed for a three-dimensional appreciation of the TFCC. Image quality and time expenditure limit the approach’s usefulness as a diagnostic tool.