Case Challenge

Hand & Wrist

Stephen J Pomeranz

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

Case Review

Musculoskeletal (MSK)

Post-Course Activities

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

Hand MRI Cases

Case 16 - 48-year-old male presents with dull pain in right hand

<div>HISTORY:&#160;This 48-year-old male presents with constant severe dull pain in right hand with lack of motion with index finger for six months. There is numbness and weakness in thumb and finger, discoloration, and difficulty lifting and using hand. Work injury.BOTH FLEXOR POLLICIS AND EXTENSOR POLLICIS TENDONS ARE INTACT: True.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS: Susceptibility artifact around the index finger and thumb limits evaluation. Deformity in the base of the proximal phalanx of the index finger probably due to old fracture. Markedly thickened radial collateral ligament of the 2nd metacarpophalangeal joint probably old sprain. Moderate-severe thickening of the ulnar collateral ligament of the 2nd metacarpophalangeal. The 2nd flexor tendon is chronically hypertrophic and tendinopathic from the level of&#160;carpometacarpal articulation and obscured by artifact at the level of metacarpophalangeal joint. Suspected partial tear as discussed in conclusion.&#160;The tendon is attenuated in appearance beyond the metacarpophalangeal joint. The extensor tendon is attenuated in appearance and not very well evaluated due to artifact.&#160;The flexor pollicis tendon intact. Visualized extensor pollicis tendon intact.&#160;Fibrosis change at the radial aspect of the head of the 4th metacarpal.&#160;No acute muscle strain.&#160;IMPRESSION: Right Hand: The index finger and the thumb obscured by surgical susceptibility artifact. Chronic moderate-severe hypertrophic tendinopathy of the 2nd flexor tendon from the level of carpometacarpal joint to the metacarpophalangeal joint. High grade tear with laxity or mild retraction at the mid/ distal third metacarpal. Suspect injury or tear at 2nd metacarpophalangeal joint but this area is obscured.Thickened capsule and collateral ligaments of 2nd metacarpophalangeal joint.Deformity of the base of the 2nd proximal phalanx probably old fracture.Fibrocystic change of 4th metacarpal head, osteoarthritic in origin.</div>

Case

Both the flexor pollicis and extensor pollicis tendons are intact.