29-year-old female with wrist discomfort for four months
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29-year-old female with complaint of left wrist discomfort for the last four months. No known injury. No pain. Evaluate for mass and flexor tenosynovitis.
Long- and short-axis fat- and water-weighted images were performed. 1.5T High Field Oval.
- A 2.2cm (CC) x 1cm (ML) X 0.5cm (AP) soft tissue mass with well-defined contours is seen deep to the flexor tendons starting at the level of 3rd metacarpal base and extending distally. The lesion is iso-slightly hyperintense to musculature on T1 slightly hyperintense on T2 and demonstrates ferromagnetic susceptibility artifact on sagittal T2 gradient-echo series. Constellations of these findings are most consistent with giant cell tumor of tendon sheath. Differential considerations may include fibrous tumors. No malignant features are identified.
- Median nerve signal intensity and contours are preserved. Guyon’s canal is normal. Flexor and extensor tendons are intact.
- No macrofracture or bony contusion.
- No substantive arthropathic change in the wrist or carpometacarpal joints. Capsulosynovial cyst formation arising from the pisotriquetral joint is noted.
- Triangular fibrocartilage demonstrates pinhole defect in the central zone. Mild distention of the distal radioulnar joint.
- Scapholunate lunatotriquetral ulnolunate and radiolunate ligaments are intact. Mild volar and dorsal capsulitis of the carpal bones is present.
- Musculature is normal.
- A 2.2cm (CC) x 1cm (ML) X 0.5cm (AP) soft tissue mass deep to the flexor tendons starting at the level of 3rd metacarpal base and extending distally most likely a giant cell tumor of tendon sheath. Differential considerations may include fibrous tumors. No malignant features are identified.
- Triangular fibrocartilage demonstrates pinhole defect in the central zone. Mild distention of the distal radioulnar joint.
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