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 78-year-old male presents with swelling and pus. Status post removal of infected fingernail, right hand.(QUIZ ANSWER) IS A FINDING IN THIS CASE:&#160;All of the above.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS: Images performed with a dedicated microcoil.Fluid collection is seen distally at the thumb, roughly 11mm in diameter. Marked cortical destruction of the distal phalanx with osseous edema extending to the IP joint of the thumb. Swelling of both radial and lateral collateral ligament fibers. Although subtle, foci of distal epiphyseal proton-density signal hyperintensity proximal phalanx of the thumb noted with preserved T1 signal intensity, subcutaneous edema extends towards the distal diaphysis of the thumb in the proximal phalanx.&#160;CONCLUSION:&#160;1. Distal subcutaneous fluid collection. Osteomyelitis distal phalanx of the thumb without IP joint space effusion. Foci of proton-density signal hyperintensity within the head proximal phalanx without associated T1 signal change, favor regional edema without osteomyelitis.&#160;2. Imaging performed in the dedicated microcoil.&#160;3. Patient refused IV contrast administration, but none needed.&#160;4. No tenosynovitis extending towards the MCP articulation.</div>

Case

Osteomyelitis distal phalanx without IP joint space effusion

Swelling of both radial and lateral collateral ligament fibers

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