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

<div>HISTORY:&#160;This 57-year-old male presents with right wrist freezing and locking up after injury two weeks prior.&#160;Complains of pain in the ulnar aspect of the wrist with limited range of motion.(QUIZ ANSWER) PRIMARY FINDING:&#160;Palmer 2 C abnormality.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS:&#160;Osseous signal and density fragment just proximal to the triquetrum measures 2.6mm.&#160;In conjunction with osteoedema of the triquetrum, strongly favor ulnotriquetral impaction syndrome with resultant capsular swelling.&#160;Rent or dehiscence in the ulnar capsule identified at the capsular condensation distally (e.g. UCL).The etiology of the ossific body would include remote fracture as a small corticated fragment; focal hydroxyapatite deposition disease or HADD; and least likely developmental ossicle.&#160;Diffusely swollen is the ulnar capsule and ulnotriquetral ligament.&#160;Homologue and peripheral synovium inflamed.LT ligament inflamed but intact.Additionally is evidence of Palmer 2C ulnolunate abutment syndrome with central third TFC chronic tear and broad-based lunate OCD.&#160;Variance on static MRI and slight pronation is neutral but may be positive in varying degrees of pronation, supination, or wrist grip.Scapholunate ligament intact.Type 2 lunate with small lunatohamate articulation and erosion at the base of the hamate, 1.5mm.Minimally inflamed 1st CMC.&#160;Small area of ligamentous ossification in the deep AOL or anterior oblique ligament of the 1st CMC.CONCLUSION:Diffusely inflamed and synovitic ulnar capsule with evidence of: Ulnotriquetral abutment; ossific body which may be intermittently trapped and produced locking; Palmer 2C ulnolunate abutment; an inflamed but intact LT ligament.</div>

Case

Under which Palmer classification of TFCC abnormalities does the triangular fibrocartilage in this case qualify?