Wrist Injury Types Explained: TFCC Tears to Carpal Tunnel

TFCC Tear

The triangular fibrocartilage complex is a cartilage and ligament structure on the ulnar (pinky) side of the wrist that cushions the joint and stabilizes the distal radioulnar joint. TFCC tears cause ulnar-sided wrist pain, clicking, and weakness with gripping or twisting. Traumatic tears from falls or sports may heal with immobilization, while degenerative tears are common with aging. MRI or MR arthrogram is the primary diagnostic tool. Learn how to identify TFCC tears on imaging in our wrist MRI reading guide.

Scaphoid Fracture

The most commonly fractured carpal bone, the scaphoid is vulnerable during falls on an outstretched hand. The fracture may not appear on initial X-rays, leading to delayed diagnosis. Pain in the anatomical snuffbox is the classic clinical sign. The scaphoid's unique blood supply makes nonunion and avascular necrosis real concerns. For detailed information on healing options, see our article on scaphoid fracture healing without surgery.

Carpal Tunnel Syndrome

Carpal tunnel syndrome occurs when the median nerve is compressed as it passes through the carpal tunnel at the wrist. Symptoms include numbness, tingling, and pain in the thumb, index, middle, and ring fingers, often worse at night. Causes include repetitive hand use, pregnancy, diabetes, and thyroid disorders. Mild cases respond to splinting and activity modification, while severe cases with muscle wasting require surgical release. MRI can show nerve swelling and flattening within the tunnel.

De Quervain's Tenosynovitis

This condition involves inflammation of the tendons on the thumb side of the wrist, specifically the abductor pollicis longus and extensor pollicis brevis. It causes pain with thumb movements, gripping, and wrist deviation. Common in new parents from repetitive lifting and in people who perform repetitive pinching motions. Treatment includes thumb spica splinting, corticosteroid injection (highly effective with 80 percent resolution), and rarely surgical release of the first dorsal compartment.

Ganglion Cyst

Ganglion cysts are the most common soft tissue mass in the hand and wrist. They are fluid-filled sacs arising from joint capsules or tendon sheaths, most commonly on the dorsal (back) wrist. Most ganglions are painless and may fluctuate in size. Treatment ranges from observation (many resolve spontaneously) to aspiration or surgical excision for symptomatic cysts. MRI clearly shows the cystic nature and origin of the mass, distinguishing it from other soft tissue tumors.

Key Takeaways

• TFCC tears cause ulnar-sided wrist pain and may need MR arthrogram for accurate diagnosis
• Scaphoid fractures can be occult on X-ray and carry unique healing challenges due to blood supply
• Carpal tunnel syndrome ranges from mild to severe and treatment depends on nerve compression degree
• De Quervain's tenosynovitis responds well to corticosteroid injection in most cases

Frequently Asked Questions