Case Challenge

Hand & Wrist

Stephen J Pomeranz

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

Case Review

Musculoskeletal (MSK)

Case 1 - 63-year-old female presents with pain in left hand

Case 2 - 67-year-old male presents with painful mass on left hand

Case 3 - 59-year-old female presents with dog bite on right hand

Case 4 - 15-year-old male presents with pain and lump on right hand

Case 5 - 14-year-old male presents with right hand pain following injury

Case 6 - 57-year-old female presents with left hand hyperesthesia

Case 7 - 48-year-old female presents with dorsal mass on right hand

Case 8 - 50-year-old male presents with swelling of the right hand

Case 9 - 64-year-old male presents with palmar pain in left hand

Case 10 - 61-year-old female presents with a mass on the right hand

Case 11 - 15-year-old male presents with finger pain in right hand

Case 12 - 55-year-old female presents with pinching pain in left hand

Case 13 - 53-year-old male presents with lump at base of index finger

Case 14 - 47-year-old female presents with mild pain in right hand

Case 15 - 58-year-old male presents with mild swollen distal 3rd digit

Case 16 - 48-year-old male presents with dull pain in right hand

Case 17 - 56-year-old female presents with bump at the base of small finger

Case 18 - 41-year-old male presents with right hand pain

Case 19 - 55-year-old male presents with psoriatic arthritis

Case 20 - 30-year-old female presents with fibrolipoma in right hand

Case 21 - 55-year-old female presents with small mass on left hand ring finger

Case 22 - 50-year-old male cannot bend left hand ring finger fully

Case 23 - 57-year-old male presents with pain in right hand

Case 24 - 65-year-old female presents with pain and swelling of the right hand

Case 25 - 61-year-old male unable to straighten fingers on right hand

Course Evaluation

Post-Course Activities

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

Hand MRI Cases

<div>HISTORY:&#160;This 61-year-old female presents with a mass on the dorsal right hand.THERE ARE NO CHARACTERISTICS TO SUGGEST:&#160;Chondrosarcoma.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS: Multifocal areas of ectopic ossification are present surrounding the 3rd digit. The foci are innumerable and occupy the dorsal capsule. One lies along the radial aspect of the capsule under the extensor tendon oblique band measuring approximately 4mm. Another more proximal along the distal diaphysis is also ossified and measures 7.5 x 5.9mm and resides in the interosseous muscles. A third more distal area intracapsular residing on the dorsal capsule of the proximal phalanx is more multifocal yet the side-to-side dimension of the three areas of ossific interest is almost a centimeter.&#160;On the ulnar side are at least four areas of mass some chondral and some chondroosseous which measure approximately 7.5mm each and are four in number.&#160;Favor the diagnosis of intra- and extraarticular synovial osteochondromatosis and synovial chondromatosis.&#160;Soft tissue chondroma based on the size and geography would be a less likely consideration.&#160;As no direct communication with the bone itself is discerned, juxtacortical chondroma or chondral lesion arising directly from the bone seems unlikely but plain film is requested for corroboration in this regard as there are subtle areas of periosteal nonaggressive reaction.&#160;The joint of the 3rd digit is arthropathic with subchondral pseudocysts and swelling.&#160;No other joint appears involved.&#160;CONCLUSION:&#160;Ossific- and chondral-appearing masses of varying size and number described in the body of the report associated with an arthropathic joint the majority of which are intraarticular and the diagnosis of synovial osteochondromatosis and chondromatosis both intraarticular- and soft tissue-related are favored over a primary chondroid lesion. Still, there are no characteristics to suggest an aggressive process such as a chondrosarcoma. Entities such as primary juxtacortical multifocal chondromas, turret exostoses, soft tissue chondroma, and multifocal osteochondromas were all considered in the differential.</div>

Case

Primary juxtacortical multifocal chondromas

There are no characteristics to suggest which of the following potential differentials?