Wrist tfcc tear - degenerative but I was injured

[Moley21]

Hi, in October 2012  a resident where I work suddenly clamped my wrist between her knees - in the immediate aftermath I experienced pain and sweeling of the ulna side of my wrist. I have just seen a consultant who wrote a report to my GP saying I probably had a degenerative tear to the tfcc, and he has prescribed a cortisone injection in the first instance. I am confused by this, as all my symptoms started after my wrist got clamped. I have been off work since October and am having my wages paid as my absense is due to an accident at work. However, the term 'degenerative' seems to imply that the accident didn't cause the tear. Does anyone have any ideas?

[Kurizu]

I see, the consultant based his diagnosis on the x-ray result which showed a slightly longer ulna, which usually causes degenerative tears on the TFCC.  You might have degenerative tears on the TFCC even before the trauma.  And the injury in your wrist only aggravated the condition.

[Moley21]

Thank you Kurizu. No I didn't have an MRI scan. I was first sent to a physio who said I would need an MRI scan and an operation, but when I was referred to the consultant, he just got me an Xray. On the report he sent to my GP he mentions impingement symptoms and that my ulna is slightly longer then my radius. Yes I will ask him for further clarification, Thanks again

[Kurizu]

Did you underwent MRI  before the diagnosis? Try to ask the consultant why he diagnosed it as degenerative and not traumatic, since, according to you, it was caused by the clamping of your wrist between the knees of the resident.  

The triangular fibrocartilage complex (TFCC) tears may be traumatic (type 1) or degenerative (type 2). With type 1 TFCC tears, there may be a history of recent wrist trauma or a fall onto an outstretched hand. With type 2 TFCC tears, the individual may report a history of previous wrist injury.  

A traumatic tear typically involves the cartilaginous disc, but also may involve the support ligament.  Degenerative TFCC tears typically result from chronic overloading of the wrist joint and may also occur in individuals with thin disc cartilage and in those with a congenitally long ulna that can cause pinching of the TFCC. Not all degenerative tears are symptomatic.

It's possible that the consultant based the diagnosis on the MRI findings which is typical of degenerative tears.

There's no harm if you seek clarification with the diagnosis.

I hope this information will help you.