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 48-year-old male presents with constant severe dull pain in right hand with lack of motion with index finger for six months. There is numbness and weakness in thumb and finger, discoloration, and difficulty lifting and using hand. Work injury.BOTH FLEXOR POLLICIS AND EXTENSOR POLLICIS TENDONS ARE INTACT: True.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS: Susceptibility artifact around the index finger and thumb limits evaluation. Deformity in the base of the proximal phalanx of the index finger probably due to old fracture. Markedly thickened radial collateral ligament of the 2nd metacarpophalangeal joint probably old sprain. Moderate-severe thickening of the ulnar collateral ligament of the 2nd metacarpophalangeal. The 2nd flexor tendon is chronically hypertrophic and tendinopathic from the level of&#160;carpometacarpal articulation and obscured by artifact at the level of metacarpophalangeal joint. Suspected partial tear as discussed in conclusion.&#160;The tendon is attenuated in appearance beyond the metacarpophalangeal joint. The extensor tendon is attenuated in appearance and not very well evaluated due to artifact.&#160;The flexor pollicis tendon intact. Visualized extensor pollicis tendon intact.&#160;Fibrosis change at the radial aspect of the head of the 4th metacarpal.&#160;No acute muscle strain.&#160;IMPRESSION: Right Hand: The index finger and the thumb obscured by surgical susceptibility artifact. Chronic moderate-severe hypertrophic tendinopathy of the 2nd flexor tendon from the level of carpometacarpal joint to the metacarpophalangeal joint. High grade tear with laxity or mild retraction at the mid/ distal third metacarpal. Suspect injury or tear at 2nd metacarpophalangeal joint but this area is obscured.Thickened capsule and collateral ligaments of 2nd metacarpophalangeal joint.Deformity of the base of the 2nd proximal phalanx probably old fracture.Fibrocystic change of 4th metacarpal head, osteoarthritic in origin.</div>

Case

Both the flexor pollicis and extensor pollicis tendons are intact.