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12b - Answer: 20-year-old male presents with crush injury of the left forearm

Pomeranz, Stephen
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
Includes DICOM files

HISTORY: 

This 20-year-old male presents with crush injury of the left forearm from three months prior.

(QUIZ ANSWER) MYOEDEMA, IN THIS CASE, INVOLVES:

All of the above.

Using the diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.

FINDINGS:

No bony macrofracture or contusion. 

Diffuse myoedema of the deep muscles of the forearm with an about 1.3cm in diameter and 4.5cm in length seroma or chronic hematoma within the flexor digitorum profundus. No substantive muscle atrophy or fatty infiltration. Small area of low-grade strain of extensor pollicis longus muscle. Muscle edema of the proximal flexor carpi radialis. 

Neuroedema of the median nerve. The ulnar nerve is normal in size and signal intensity. The radial nerve is unremarkable. 

The common flexor and extensor tendons are intact. 

Biceps and triceps tendons are intact. 

CONCLUSION: 

1. Myoedema involving the flexor carpi radialis, flexor digitorum profundus, and abductor pollicis longus muscles. Intramuscular hematoma or a seroma at the flexor digitorum profundus. 

2. Neuroedema of the median nerve may reflect crush phenomenon.

LESSON 2, TOPIC 36

Case Challenge: Forearm MRI Cases

Case Challenge

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Content reviewed: July 19, 2021

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