Case Challenge

Hand & Wrist

Stephen J Pomeranz

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

Case Review

Musculoskeletal (MSK)

Case 1 - 35-year-old female presents with pain shooting to right fingers

Case 2 - 15-year-old female gymnast presents with pain of right wrist

Case 3 - 26-year-old female presents with right wrist pain

Case 4 - 14-year-old female presents with ulnar-sided left wrist pain for three weeks

Case 5 - 36-year-old female presents with right wrist pain

Case 6 - 19-year-old male presents with pain mid dorsal right wrist

Case 7 - 58-year-old female presents with mild pain in right wrist

Case 8 - 68-year-old male presents with ulnar-sided left wrist pain

Case 9 - 13-year-old male presents with moderate right wrist pain

Case 10 - 36-year-old female patient was boxing, and hit her partner's elbow

Case 11 - 18-year-old male presents with pain and weakness in left wrist for two weeks

Case 12 - 53-year-old male presents with moderate to severe, sharp and dull, right wrist pain

Case 13 - 59-year-old female presents with severe pain and swelling in right wrist

Case 14 - 67-year-old female presents with rheumatoid arthritis

Case 15 - 60-year-old female presents with ulnar-sided pain in right wrist

Case 16 - 43-year-old male presents with right wrist pain, and right thumb numbness

Case 17 - 62-year-old male presents with possible scapholunate injury

Case 18 - 46-year-old male presents with left wrist pain, swelling, and stiffness

Case 19 - 32-year-old male presents with volar right wrist swelling

Case 20 - 50-year-old female presents with left wrist pain since feeling a pop

Case 21 - 45-year-old female presents with laceration in right wrist

Case 22 - 49-year-old female presents with injury of the left wrist

Case 23 - 57-year-old male presents with right wrist pain

Case 24 - 59-year-old male presents with mild dull pain when pushing on right wrist

Case 25 - 19-year-old female presents with history of ganglion cyst

Case 26 - 53-year-old female presents with radial pain in the left wrist

Case 27 - 17-year-old male presents with pain in left wrist since fall

Case 28 - 55-year-old female presents with right ulnar region mass

Case 29 - 68-year-old female presents with pain in right wrist

Case 30 - 43-year-old female tripped 10 days ago, and landed on her left wrist

Case 31 - 36-year-old male presents with pain in ulnar aspect of right wrist

Case 32 - 50-year-old male presents with radial-sided right wrist pain since work-related falling injury

Case 33 - 64-year-old female presents with left wrist pain for one month

Case 34 - 67-year-old female presents with moderate pain and lump on right wrist

Case 35 - 51-year-old female presents with a left wrist pain

Case 36 - 14-year-old female presents with mild to moderate, constant dull pain in right wrist

Case 37 - 16-year-old male presents with mild to moderate pain and swelling in right wrist for five months

Case 38 - 16-year-old female presents with worsening left wrist pain, and swelling

Case 39 - 20-year-old male presents with pain with flexion and extension

Case 40 - 55-year-old female presents with right wrist pain and swelling

Case 41 - 31-year-old male presents with pain around the scaphoid region of the left wrist

Case 42 - 11-year-old female presents with chronic left wrist pain

Case 43 - 50-year-old female presents with mass in right wrist

Case 44 - 43-year-old female presents with pain in right wrist

Case 45 - 36-year-old female presents with right wrist pain for several years

Case 46 - 35-year-old female presents with right wrist triangular fibrocartilage complex (TFCC) pain

Case 47 - 55-year-old male presents with a one year history of episodic left wrist pain

Case 48 - 57-year-old male presents with right wrist freezing and locking up

Case 49 - 21-year-old female presents with palmar right wrist pain over the carpal tunnel region

Case 50 - 39-year-old male presents with left wrist pain since injury seven months prior

Course Evaluation

Post-Course Activities

This Power Pack is comprised of 50 unique Wrist MRI cases that you can scroll through in our diagnostic web viewer to determine your findings. Quiz yourself and earn CME.

Wrist MRI Cases

<div>HISTORY:&#160;This 67-year-old female presents with moderate pain and lump on right wrist. For the past two months, there has been a sharp pinching while using the right hand or lifting objects.(QUIZ ANSWER) PRIMARY FINDING:&#160;Intersection syndrome.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS: Dominant abnormalities are noted involving the 2nd and 3rd extensor compartments manifest as distal intersection syndrome beginning just proximal to the wrist. High-grade peritendinitis and partial high-grade tear involving the 3rd extensor tendon compartment (extensor pollicis longus) as it passes over the Lister's tubercle and over the 2nd extensor compartment (extensor carpi radialis longus and brevis). The 4th, 5th, 6th and 1st extensor tendon compartments appear normal. The peritendinitis and peritendinous fluid, however, continues distally along the tendons making up the 2nd compartment (carpi radialis longus and brevis).&#160;Extensive resorptive cystic change, likely arthropathic, noted involving the lunate, triquetrum and proximal half of the capitate. Mild generalized wrist capsulosynovitis noted with thickening and heterogeneous signal.&#160;Normal radioulnar, radiocarpal, midcarpal and carpometacarpal alignment.&#160;Normal radioulnar joint.&#160;Central full-thickness perforation or tear involving the central band of the triangular fibrocartilage with free communication of fluid between ulnocarpal joint and distal radioulnar joint.Normal scapholunate and lunotriquetral ligaments.&#160;No soft tissue mass.&#160;Subtle hyperintensity involving the thenar eminence is noted and there is a moderate caliber change in the size of the median nerve from proximal to distal carpal tunnel. Carpal tunnel syndrome requires clinical exclusion.&#160;No soft tissue mass, carpal boss, macrofracture, microtrabecular injury, AVN noted.&#160;IMPRESSION: Right Wrist: Distal intersection syndrome with peritendinous inflammation and tenosynovitis involving the 2nd extensor compartment and peritendinous inflammation with high-grade partial tear involving the 3rd extensor tendon compartment - as the 3rd extensor tendon compartment passes over Lister's tubercle dorsal to the 2nd tendon compartment in its distal course. The peritendinous inflammation of the tendons of the 2nd extensor compartment extend distally into the hand.&#160;Extensive arthropathic cystic resorptive changes involving the lunate, triquetrum, scaphoid and proximal half of the capitate.&#160;Generalized capsulosynovitis with capsular thickening, scant fluid in the intercarpal joints and synovitis.&#160;Central full-thickness perforation or tear involving the central band of the triangular fibrocartilage with free communication of fluid between ulnocarpal joint and distal radioulnar joint.Subtle hyperintense signal involving the muscles of the thenar eminence for which median nerve impingement is suspected. Moderate caliber change is noted involving the proximal carpal location of the median nerve compared to its distal carpal location. Consider carpal tunnel syndrome.</div>

Case

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