Case Challenge

Stephen J Pomeranz

Gain confidence interpreting Forearm MRI Cases with MRI Online. Quiz yourself using real-world, interactive scrollable cases & earn CME. Try it free!

Case Review

Musculoskeletal (MSK)

Case 1 - 24-year-old female presents with history of left forearm venous malformation

Case 2 - 37-year-old female presents with pain, crepitus, and swelling of the right forearm

Case 3 - 34-year-old male pulled muscle while wakeboarding

Case 4 - 59-year-old male presents with extensive swelling at the left elbow and forearm

Case 5 - 3-year-old male presents with a left forearm mass

Case 6 - 64-year-old female presents with small lumps on the right forearm for six weeks

Case 7 - 65-year-old female presents with left forearm swelling and burning

Case 8 - 61-year-old male presents with mass at right wrist and forearm

Case 9 - 48-year-old male presents with lump on the volar right forearm for 12 years

Case 10 - 44-year-old male is being evaluated for cyst

Case 11 - 40-year-old female presents with left hand pain

Case 12 - 20-year-old male presents with crush injury of the left forearm

Case 13 - 27-year-old male is being evaluated for right forearm strain

Case 14 - 33-year-old male presents with volar right forearm mass

Case 15 - 49-year-old male presents with left elbow pain, swelling, and redness

Case 16 - 67-year-old female is being evaluated for lesion in left forearm

Case 17 - 65-year-old female presents with inability to extend thumb or fingers

Case 18 - 27-year-old female was hit in right arm by the trunk of a car

Case 19 - 70-year-old male presents with lump on right forearm

Case 20 - 58-year-old female presents with severe soft tissue swelling medial ulnar aspect

Case 21 - 59-year-old female presents with mass distal left forearm

Case 22 - 15-year-old male presents with ulnar pain in left forearm

Case 23 - 41-year-old female presents with clinical radial neuropathy

Case 24 - 2-year-old female presents with multiple osseous lesions in left forearm

Case 25 - 62-year-old male presents with paralysis of the left index finger and thumb

Course Evaluation

Post-Course Activities

This Power Pack is comprised of 25 unique Forearm MRI cases that you can scroll through in our diagnostic web viewer to determine your findings. Quiz yourself and earn CME.

Forearm MRI Cases

<div>HISTORY:&#160;This 64-year-old female presents with small lumps on the right forearm for six weeks. (QUIZ ANSWER) POTENTIAL DIFFERENTIAL DIAGNOSIS IN THIS CASE:&#160;All of the above.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS: The bones are in anatomic alignment. The bone marrow signal is normal without evidence of occult fracture, stress fracture or bone contusion. Mild elbow joint arthrosis noted. Bone fragments are seen adjacent to the medial epicondyle suggesting remote injury/old avulsion fracture. Mild wrist arthrosis also noted with small radioulnar joint effusion. A volar cystic lesion is noted extending from the ulnocarpal articulation, possibly representing a small ganglion or capsulobursal cyst.&#160;The visualized muscles are intact. No evidence of hemorrhage, tear or strain.&#160;The visualized tendons are without abnormality.&#160;Multiple ill-defined, subcutaneous, low T1 and T2 signal lesions are noted extending along the dorsal forearm, predominantly medially, with several lesions also noted anterolaterally at the level of the wrist. Differential diagnosis includes amyloid deposits, fibromatosis, and multiple desmoids.&#160;CONCLUSION:&#160;1. Multiple, ill-defined subcutaneous lesions all along the forearm predominantly dorsomedially with several lesions anterolaterally at the level of the wrist for which the differential diagnosis includes erythema nodosum, multifocal immune-mediated nodular fasciitis, proliferative fasciitis and less likely sarcoid, amyloid deposits, fibromatosis (unlikely) and multiple desmoids. Tissue sampling recommended.&#160;2. Moderate elbow arthrosis, with suggestion of remote avulsion injury of the medial epicondyle.&#160;3. Moderate wrist arthrosis with small radioulnar effusion and small volar ulnocarpal capsulobursal cyst or ganglion.</div>

Case

Multifocal immune-mediated nodular fasciitis

In this case, there are multiple, ill-defined subcutaneous lesions all along the forearm, predominantly dorsomedially with several lesions anterolaterally at the level of the wrist. Which of the following should be considered as a differential diagnosis?