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 59-year-old male presents with extensive swelling at the left elbow and forearm for the last six days, progressively getting worse. Deficit felt in brachioradialis and flexor muscle area.(QUIZ ANSWER) MOST LIKELY CAUSE OF SWELLING:&#160;Olecranon bursitis.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS: A 10cm x 2.5cm x 1.5cm fluid collection is noted in the dorsal aspect of the elbow and proximal forearm with synovial proliferation within the collection. Surrounding subcutaneous soft tissue edema is also noted. No soft tissue component identified. Adjacent musculature and osseous structures are intact. No fascial involvement identified. Constellation of these findings suggestive of olecranon bursitis. Favor gout, crystalline disease or other. Degloving less likely.No recent macrofracture or bony contusion identified. Osseous alignment is within normal limits. No substantive joint effusion. No osteoarthritic changes. No high-grade chondromalacia or osteochondral defect.&#160;Radial and ulnar collateral ligaments as well as lateral ulnar collateral ligament are intact.&#160;Common, flexor and extensor tendons are intact.&#160;Triceps, brachialis and biceps tendons are within normal limits.&#160;Radial and median nerve contours are intact. No signal alteration. Anconeus epitrochlearis muscle and mild T2 signal increase in the ulnar nerve may suggest cubital tunnel entrapment. No substantive evidence of muscle edema or atrophy in the forearm.&#160;Small capsulitis of the elbow joint.&#160;CONCLUSION:&#160;1. A 10cm x 2.5cm x 1.5cm fluid collection in the dorsal aspect of the elbow and proximal forearm with synovial proliferation within the collection. Surrounding subcutaneous soft tissue edema. Constellation of these findings suggestive of olecranon bursitis. Favor gout, crystalline disease or other. Degloving less likely. Aspiration should be entertained for therapy and diagnosis.2. Anconeus epitrochlearis accessory muscle with mild swelling of the ulnar nerve. Assessment for ulnar neuropathy (carpal tunnel syndrome) is recommended.</div>

Case

Given the constellation of findings in this case, what is the MOST LIKELY cause of the swelling seen in both the forearm and elbow?