Wk 2, Case 4 - Review

Patient History
62-year-old female with progressively enlarging right index finger painful mass.

Findings

LIGAMENTS: Thickening of the ulnar and radial collateral interphalangeal ligaments of the thumb.

OSSEOUS: Moderate osteoarthrosis of the thumb interphalangeal joint with marginal beak osteophytes. No pressure erosions.

TENDONS: A 2.5cm x 1.5cm x 0.8cm (craniocaudal, transverse and AP dimensions) lobulated solid mass arising from the palmar, radial aspect of the thumb at the level of the interphalangeal joint demonstrating low to intermediate T1 and T2 signal intensity with blooming artifact and subtle heterogeneous enhancement. The mass appears to arise from the palmar tendon sheath.

Impressions
1.Lobulated solid mass with blooming artifact and subtle enhancement at the palmar radial aspect of the interphalangeal joint of the right thumb in keeping with a tenosynovial giant cell tumor (a.k.a giant cell tumor of the tendon sheath “GCTTS”, pigmented villonodular tumor of the tendon sheath (PVNTS) or extraarticular pigmented villonodular tumor of the tendon sheath). No osseous erosions.
2.Moderate osteoarthrosis of the thumb IP joint.