Case Challenge

Hand & Wrist

Thumb & Finger

Stephen J Pomeranz

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

X-Ray (Plain Films)

Case Review

Musculoskeletal (MSK)

Case 1 - 54-year-old male presents with severe pain in left hand and thumb

Case 2 - 33-year-old male presents with pain in the right thumb

Case 3 - 19-year-old male presents with hyperextension of left thumb

Case 4 - 50-year-old male presents with left thumb pain

Case 5 - 15-year-old female is being assessed for ulnar collateral ligament tear in right thumb

Case 6 - 69-year-old male presents with left thumb dislocation one week prior

Case 7 - 49-year-old male presents with Gamekeeper's thumb, left

Case 8 - 43-year-old female presents with constant severe pain in right thumb

Case 9 - 64-year-old female presents with history of mass in left thumb

Case 10 - 45-year-old male presents with sprain of the metacarpophalangeal joint

Case 11 - 59-year-old male is being evaluated for glomus tumor, right thumb mass

Case 12 - 58-year-old female presents with mass in the right index finger

Case 13 - 75-year-old male presents with left thumb pain

Case 14 - 62-year-old male presents with mass / swelling in the left thumb

Case 15 - 62-year-old female fell three weeks prior, injuring left thumb

Case 16 - 78-year-old male presents with swelling and pus

Case 17 - 22-year-old male presents with constant dull sore / swollen ring finger

Case 18 - 16-year-old male is being evaluated for right thumb nail lesion

Case 19 - 15-year-old female was playing volleyball, hyperextended thumb six weeks prior

Case 20 - 44-year-old male presents with chronic left thumb pain

Case 21 - 37-year-old female presents with mass at the top of the nail bed of the left thumb

Case 22 - 53-year-old female fell at work, and has lingering right thumb pain

Case 23 - 60-year-old female presents with injury to left thumb seven weeks prior

Case 24 - 64-year-old male presents with right thumb soft tissue lesion

Case 25 - 58-year-old female presents with history of motor vehicle accident

Course Evaluation

Post-Course Activities

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

Thumb & Finger MRI Cases

<div>HISTORY:&#160;This 62-year-old male presents with mass / swelling in the left thumb near the IP joint.(QUIZ ANSWER) IS MOST LIKELY A FINDING IN THIS CASE:&#160;Ganglion pseudocyst.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS: No macrofracture or bony contusion identified. A 1cm x 0.9cm x 0.3cm, lobulated, cystic structure demonstrating mild peripheral, pseudocapsular enhancement is seen at the dorsal aspect of the proximal phalanx of the thumb. This lesion most likely arises from the ulnar collateral ligament of the MCP or sagittal band and represents a ganglion pseudocyst.&#160;Metallic susceptibility artifact is seen at the ulnar aspect cutaneous tissue of the thumb at the level of mid shaft of the proximal phalanx, consistent with foreign object at this location.&#160;T1 and T2 hypointense soft tissue with ill-defined contours is noted proximal to the foreign object. This area demonstrates mild enhancement on postcontrast series and may represent fibroinflammatory tissue. No discrete mass is identified.&#160;Increased T1 signal of the flexor tendon of the thumb may suggest mild tendinopathy. No retracted tear identified.&#160;No evidence of osteomyelitis. No arthritis of the MCP or IP joints of the thumb.&#160;CONCLUSION:&#160;1. A 1cm x 0.9cm x 0.3cm, lobulated, cystic structure demonstrating mild peripheral, pseudocapsular enhancement at the dorsal aspect of the proximal phalanx of the thumb, most likely a ganglion pseudocyst arising from the ulnar collateral ligament of the MCP or sagittal band. Consider epidermoid inclusion.&#160;2. Fibroinflammatory tissue and metallic susceptibility artifact at the level of proximal phalanx of the thumb.&#160;3. No evidence of osteomyelitis.&#160;4. Mild tendinopathy of the flexor tendon.</div>

Case

Arthritis of the interphalangeal (IP) joint

With regard to the thumb, which of the following IS MOST LIKELY a finding in this case?