Case Challenge

Stephen J Pomeranz

Gain confidence interpreting Forearm MRI Cases with MRI Online. Quiz yourself using real-world, interactive scrollable cases & earn CME. Try it free!

Case Review

Musculoskeletal (MSK)

Case 1 - 24-year-old female presents with history of left forearm venous malformation

Case 2 - 37-year-old female presents with pain, crepitus, and swelling of the right forearm

Case 3 - 34-year-old male pulled muscle while wakeboarding

Case 4 - 59-year-old male presents with extensive swelling at the left elbow and forearm

Case 5 - 3-year-old male presents with a left forearm mass

Case 6 - 64-year-old female presents with small lumps on the right forearm for six weeks

Case 7 - 65-year-old female presents with left forearm swelling and burning

Case 8 - 61-year-old male presents with mass at right wrist and forearm

Case 9 - 48-year-old male presents with lump on the volar right forearm for 12 years

Case 10 - 44-year-old male is being evaluated for cyst

Case 11 - 40-year-old female presents with left hand pain

Case 12 - 20-year-old male presents with crush injury of the left forearm

Case 13 - 27-year-old male is being evaluated for right forearm strain

Case 14 - 33-year-old male presents with volar right forearm mass

Case 15 - 49-year-old male presents with left elbow pain, swelling, and redness

Case 16 - 67-year-old female is being evaluated for lesion in left forearm

Case 17 - 65-year-old female presents with inability to extend thumb or fingers

Case 18 - 27-year-old female was hit in right arm by the trunk of a car

Case 19 - 70-year-old male presents with lump on right forearm

Case 20 - 58-year-old female presents with severe soft tissue swelling medial ulnar aspect

Case 21 - 59-year-old female presents with mass distal left forearm

Case 22 - 15-year-old male presents with ulnar pain in left forearm

Case 23 - 41-year-old female presents with clinical radial neuropathy

Case 24 - 2-year-old female presents with multiple osseous lesions in left forearm

Case 25 - 62-year-old male presents with paralysis of the left index finger and thumb

Course Evaluation

Post-Course Activities

This Power Pack is comprised of 25 unique Forearm MRI cases that you can scroll through in our diagnostic web viewer to determine your findings. Quiz yourself and earn CME.

Forearm MRI Cases

<div>HISTORY:&#160;This 2-year-old female presents with multiple osseous lesions in left forearm.(QUIZ ANSWER) MOST LIKELY DIAGNOSIS IN THIS CASE:&#160;Maffucci syndrome.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS: Multiple lesions with high fluid intensity involving the distal visualized humerus, radius, ulna, ossified carpal bones and metacarpals. The lesions appear extending from the metaphysis. There are foci of hypointensity within the lesions probably representing calcification. The largest one is in the distal radius and is expansile and multilobular in contour. The diameter is about 1.3cm with a thin tail extending to the metaphysis. Small linear fluid intensity at base of the olecranon probably early lesions. No periosteum inflammation. No adjacent soft tissue edema.&#160;A few lobular hyperintense lesions within the subcutaneous tissue. The largest one is about 7mm in diameter medial to the distal humerus. The findings are suspicious for hemangiomas.&#160;The muscles are normal in signal intensity.&#160;CONCLUSION:&#160;Multiple lytic lesions with probable calcification extending from the metaphysis most likely represent polyostotic enchondromas. A few lobulated lesions in the subcutaneous fat probably hemangiomas. The constellation of the findings may represent Maffucci syndrome. Probably Madelung's deformity. Will add an addendum after obtaining x-ray.&#160;ADDENDUM:&#160;Bone survey report, from one month prior, reviewed. The expansile radial lesion likely corresponding to the described osteochondromatosis in the radius.</div>

Case

Given the constellation of findings in this case, the MOST LIKELY diagnosis would be: