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

<div>HISTORY:&#160;This 45-year-old female presents with laceration in right wrist with glass. Evaluate for foreign body.(QUIZ ANSWER) TENOSYNOVITIS EXISTS IN:All of the above.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS: Gel marker is noted along the radial aspect and dorsal aspect of the wrist. Abnormal signal is noted in the region of the extensor carpi radialis longus. Fluid is noted within the ECRB, ECRL and EPL tendon sheaths for which tenosynovitis is favored.&#160;Interstitial tearing involves the ECRL. The ECRL demonstrates a complete tear with a gap of approximately 3.15cm. This is well visualized on coronal PD SPIR as well as coronal FFE. Small foci of hypointensity on the axial datasets in the region of the ECRL may reflect a shred of remaining intact tendon or an accessory slip of tendon; however, the majority of the tendon is lacerated. No foreign body is demonstrated.&#160;Triangular fibrocartilage and its ulnar attachments are intact. Scapholunate ligament and lunotriquetral ligament are intact. Mild arthrosis involves distal scaphoid including regions of small subchondral cysts. Dorsal capsulitis is demonstrated.&#160;The axial datasets do not extend proximally into the forearm at the level of the retracted tendon.&#160;CONCLUSION:&#160;1. Tenosynovitis involves the ECRB, ECRL and EPL tendon sheaths. The ECRL is lacerated with a gap of approximately 3.15cm. The gap extends from the distal radial diametaphysis to the level of the radial styloid. Linear region of signal in this region may reflect a remaining shred of tendon or a variant slip of tendon.&#160;2. No foreign body is demonstrated.</div>

Case

In this case, tenosynovitis is favored in which of the following tendon sheaths?