CASE

Thumb – FOOSH

CASE HISTORY

Radial-sided wrist pain with limited range of motion in the thumb exacerbated when moving the thumb since work-related falling injury.

TECHNICAL FACTORS

Long- and short-axis fat- and water-weighted images were performed; 1.5T High Field Oval.

KEY IMAGES

This case has no key images.

CASE FINDINGS

  • Osseous structures appear grossly intact and exhibit normal marrow signal. Small pseudocysts or interosseous ganglia are noted in the distribution of the capitate hamate scaphoid lunate and triquetrum. The intercarpal articulations appear preserved. There is no evidence of scapholunate or lunatotriquetral ligamentous disruption. The TFC complex appears intact. 
  • Flexor and extensor tendons appear grossly intact. Diffuse fluid signal is identified surrounding the extensor pollicis brevis and abductor pollicis longus tendons. Short-segment slit-like concealed small interstitial tear is identified in the distribution of the extensor pollicis brevis and abductor pollicis longus tendons. No macrotear. Active de Quervain’s disease.

CASE CONCLUSION

  • Active de Quervain’s disease.
  • Tenosynovitis involving the extensor pollicis brevis and abductor pollicis longus tendons accompanied by short-segment slit-like concealed small interstitial tear involving the extensor pollicis brevis and swelling of the slips abductor pollicis longus tendons. This finding provides a mechanism for the radial-sided wrist pain. No macrotear.
  • No evidence of recent fracture or traumatic scapholunate dissociation.

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