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13b - Answer: 75-year-old male presents with left thumb pain

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

HISTORY: 

This 75-year-old male presents with left thumb pain.

(QUIZ ANSWER) NOT A FINDING IN THIS CASE: 

Flexor pollicis brevis tear.

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

FINDINGS:

Markedly retracted and dorsal and proximally folded UCL rupture is compatible with large Stener-type UCL tear. 

Central osteochondral erosion of the proximal phalanx is approximately 3mm deep. Narrowing of the medial joint space. 

Microtrabecular infraction of the 1st metacarpal, along its palmar aspect. 

Laxity or suspected injury of the intersesamoid ligament. 

Flexors and extensors remain intact. 

Thickening or enfolding of some capsuloligamentous tissue is seen along the palmar aspect of the joint. 

1st metacarpophalangeal joint palmar plate is swollen but intact. 

Radial collateral ligament swollen but intact. 

CONCLUSION: 

Giant Stener lesion with additional details described in the body of the report.

LESSON 2, TOPIC 39

Case Challenge: Thumb & Finger MRI Cases

Case Challenge

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Content reviewed: October 27, 2021

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