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)

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

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

<div>HISTORY:&#160;This 55-year-old male presents with a one year history of episodic left wrist pain.(QUIZ ANSWER) MORE LIKELY:&#160;Rheumatoid arthritis.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS:Neutral ulnar posture.&#160;Swelling around the peripheral TFCC attachments but no TFC disc tear.Intact SL and LT ligaments.Severe arthropathy, including joint space loss, erosions, pseudocysts and bulky spurs of the 1st CMC.&#160;Moderate osteoarthropathy throughout the remainder of the wrist.Spotty osseous edema throughout the wrist and MCPs versus bony fibrovascular action.Capsular cyst at the 1st CMC.&#160;Volar aspect radioscaphoid ganglion pseudocyst measuring 7mm.&#160;No dorsal ganglion.Intact dorsal and volar radioulnar ligaments.Normal carpal tunnel, Guyon canal, median and ulnar nerves.Mild flexor and extensor tenosynovitis without tendinosis or tear.Normal musculature.Diffuse capsulitis and capsular thickening about the wrist.CONCLUSION:1. Capsulitis, capsular thickening throughout the wrist with bone marrow edema and/or bony fibrovascular action throughout the carpus favored to reflect a consequence of repetitive microtrauma or inflammatory arthropathy with superimposed osteoarthropathy, the OA greatest at the STT articulations and 1st CMC.&#160;Consider rheumatoid arthritis or gout.2. Swelling around the TFCC but no TFCC tear or disc tear.</div>

Case

Triangular fibrocartilage complex (TFCC) tear

In this case, there is capsular thickening throughout the wrist with bone marrow edema and/or bony fibrovascular action throughout the carpus. Which of the following is the MORE LIKELY source?