Palmer classification of TFCC abnormalities

Changed by Henry Knipe, 31 Jan 2019

Updates to Article Attributes

Body was changed:

Show markup changes

Palmer classification for triangular fibrocartilage complex (TFCC) abnormalities is based on the cause, location and degree of injury ¹:

Class 1 - traumatic injury

a: central perforation of the triangular fibrocartilage (TFC) disc proper
b: ulnar avulsion with or without distal ulnar fracture
- may involve the proximal or distal lamina (foveal and styloid attachment, respectively), or both
c: distal avulsion of the TFCC involving ulnotriquetral and ulnolunate ligaments
d: radial avulsion ~~with or without~~of the TFC disc proper +/- sigmoid notch fracture

Class 2 - degenerative injury (ulnocarpal abutment syndrome)

a: TFCC wear with thinning/fraying without perforation
b: TFCC wear in 2a with lunate, triquetral and/or ulnar chondromalacia
c: TFCC perforation ~~with lunate and/or ulnar~~+/- 2b chondromalacia
d: ~~TFCC~~ lunotriquetral ligament perforation ~~with lunate~~+/ features of 2a, 2b and/or ~~ulnar chondromalacia and lunotriquetral ligament perforation~~2c
e: ~~TFCC perforation~~ any or all of above with ~~lunate and/or ulnar chondromalacia, lunotriquetral ligament perforation, and~~ ulnocarpal arthritis

~~-a: central perforation</li>~~
+a: central perforation of the triangular fibrocartilage (TFC) disc proper</li>
~~-c: distal avulsion</li>~~
+c: distal avulsion of the TFCC involving ulnotriquetral and ulnolunate ligaments</li>
~~-d: radial avulsion with or without sigmoid notch fracture</li>~~
+d: radial avulsion of the TFC disc proper +/- sigmoid notch fracture</li>
~~-a: TFCC wear</li>~~
+a: TFCC wear with thinning/fraying without perforation</li>
~~-b: TFCC wear with lunate and/or ulnar chondromalacia</li>~~
+b: TFCC wear in 2a with lunate, triquetral and/or ulnar chondromalacia</li>
~~-c: TFCC perforation with lunate and/or ulnar chondromalacia</li>~~
+c: TFCC perforation +/- 2b chondromalacia</li>
~~-d: TFCC perforation with lunate and/or ulnar chondromalacia and lunotriquetral ligament perforation</li>~~
+d: lunotriquetral ligament perforation +/ features of 2a, 2b and/or 2c</li>
~~-e: TFCC perforation with lunate and/or ulnar chondromalacia, lunotriquetral ligament perforation, and ulnocarpal arthritis</li>~~
+e: any or all of above with ulnocarpal arthritis</li>
~~-<li><a title="TFCC injury" href="/articles/triangular-fibrocartilage-complex-injury">TFCC injury</a></li>~~
+<li><a href="/articles/triangular-fibrocartilage-complex-injury">TFCC injury</a></li>

References changed:

4. Skalski MR, White EA, Patel DB, Schein AJ, RiveraMelo H, Matcuk GR. The Traumatized TFCC: An Illustrated Review of the Anatomy and Injury Patterns of the Triangular Fibrocartilage Complex. (2016) Current problems in diagnostic radiology. 45 (1): 39-50. <a href="https://doi.org/10.1067/j.cpradiol.2015.05.004">doi:10.1067/j.cpradiol.2015.05.004</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/26117527">Pubmed</a>

ADVERTISEMENT: Supporters see fewer/no ads

{"current_user":null,"inclusions":[{"imageId":1416703,"studyId":15081,"caseSlug":"triangular-fibrocartilage-complex-injury-palmer-1a","caption":"Case 1: type 1a","thumbnail":"https://prod-images-static.radiopaedia.org/images/1416703/8135c6f376c4df67c7917e00c523e5_big_gallery.jpg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":8189336,"studyId":31605,"caseSlug":"tfcc-tear-palmer-1d-5","caption":"Case 2: type 1d","thumbnail":"https://prod-images-static.radiopaedia.org/images/8189336/2de5458edb25354efaead13d74e44b_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":4184069,"studyId":23935,"caseSlug":"tfcc-injury-palmer-1b-2","caption":"Case 3: type 1b","thumbnail":"https://prod-images-static.radiopaedia.org/images/4184069/3118f1073f6a00254a0a125ae74399_big_gallery.jpg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":4962086,"studyId":25804,"caseSlug":"triangular-fibrocartilagenous-complex-tear","caption":"Case 4: type 1d","thumbnail":"https://prod-images-static.radiopaedia.org/images/4962086/baf1a5cf6c8a3207ac005e1e0734c9_big_gallery.jpg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":4865595,"studyId":25581,"caseSlug":"tfcc-injury-palmer-1b-3","caption":"Case 5: type 1b","thumbnail":"https://prod-images-static.radiopaedia.org/images/4865595/4a9e270b62a10586ab97854bf47011_big_gallery.jpg","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated"},{"imageId":8006215,"studyId":31177,"caseSlug":"tfcc-tear-palmer-1a-1","caption":"Case 6: type 1a","thumbnail":"https://prod-images-static.radiopaedia.org/images/8006215/ccb0290d0709ddc7839c0114cea6fda3bfbfebd30f029330e06096fe64bde8a9_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":8111744,"studyId":31493,"caseSlug":"degenerative-tfcc-palmer-2a-2","caption":"Case 7: type 2a","thumbnail":"https://prod-images-static.radiopaedia.org/images/8111744/0000cbdc72dfd065afde6d74a8d30d_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":8111959,"studyId":31494,"caseSlug":"tfcc-tear-palmer-1d-4","caption":"Case 8: type 1d","thumbnail":"https://prod-images-static.radiopaedia.org/images/8111959/fa36fd0c73d32d88e59d7426191183_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":8130590,"studyId":31546,"caseSlug":"degenerative-tfcc-palmer-2c-1","caption":"Case 9: type 2c","thumbnail":"https://prod-images-static.radiopaedia.org/images/8130590/d48af774d338f7dffb1fdb3fea900d_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"}],"ddx_inclusions":[],"lang":"us"}

Updating… Please wait.

Unable to process the form. Check for errors and try again.

Thank you for updating your details.

Palmer classification of TFCC abnormalities

Updates to Article Attributes

Class 1 - traumatic injury

Class 2 - degenerative injury (ulnocarpal abutment syndrome)

See also

Articles

By Section:

By System:

Cases

Radiopaedia.org