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13b - Answer: 27-year-old male is being evaluated for right forearm strain

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

HISTORY: 

This 27-year-old male is being evaluated for right forearm strain, radial tunnel syndrome.

(QUIZ ANSWER) PRIMARY FINDING IN THIS CASE: 

Radial nerve entrapment.

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

FINDINGS:

Swelling of supinator and extensor carpi radialis longus and brevis muscles more conspicuous along the musculotendinous junction. No mass effect or abnormal signal along the radial nerve or posterior interosseous nerve. No ganglion pseudocyst is present. Myoedema is more likely due to strain. No abnormality is seen in the tendinous proximal edge of the superficial head of the supinator muscle (arcade of Frohse). Along the superficial radial nerve, no abnormally is seen.

No osteochondral defect, bone contusion or fracture is present in the elbow. The olecranon demonstrates a normal configuration without evidence of spurring or hypertrophy, triceps insertional tendinopathy, or juxta-olecranon bursitis. The common flexor and extensor mechanisms are intact in the elbow.  

The scapholunate and lunotriquetral intervals and T-shaped ligaments are intact. No inflammation at the scapholunate or lunotriquetral intervals is noted. No radiocarpal arthropathy or ulnocarpal impaction syndrome is evident. The TFCC is grossly intact. 

CONCLUSION: 

Radial nerve entrapment with swelling of the supinator and extensor carpi radialis longus and brevis muscles, more conspicuous along the musculotendinous junction. No ganglion pseudocysts, mass effect or abnormal signal along the radial nerve; superficial or posterior interosseous nerves. No abnormality is seen in the tendinous proximal edge of the superficial head of the supinator muscle (arcade of Frohse) other than thickening or hypertrophy.

LESSON 2, TOPIC 39

Case Challenge: Forearm MRI Cases

Case Challenge

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Content reviewed: July 19, 2021

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