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 60-year-old female presents with injury to left thumb seven weeks prior. Patient has persistent pain and instability.(QUIZ ANSWER) IS AN EXAMPLE OF A STENER-TYPE LESION, IN THIS CASE:&#160;False.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS: Abnormal signal along the ulnar aspect of the MCP joint of the thumb for which a chronic UCL tear with scarring is favored. A coiled scarred ligament is deep to the adductor aponeurosis. No Stener lesion is demonstrated. Diffuse capsulitis involves the MCP joint. No acute osseous fracture is demonstrated. Signal along the ulnar base of the proximal phalanx may be related to scarring and / or a small sclerotic flake fracture. Plain film correlation would be of value in assessing for a small fracture in this location. Subtle blunting of the proximal phalanx base is demonstrated and a chronic fracture in this region is suspected. A proximal UCL tear which is retracted distally, balled up with surrounding scarring and inflammatory reaction could also result in this appearance. Inflammatory response contributes to poor delineation of the ligament margins.&#160;CONCLUSION:&#160;1. Diffuse abnormal signal in the expected location of the ulnar collateral ligament and MCP joint of the thumb for which chronic tearing and scarring is favored. Hypointense signal just proximal to the proximal phalanx either reflects a scarred retracted balled ligament and/or possibly a small sclerotic osseous fracture fragment and for which plain film correlation will be of value. This is deep to the adductor aponeurosis. Diffuse capsulitis at the level of the MCP joint is demonstrated.&#160;2. Please see above.</div>

Case

The ulnar collateral ligament (UCL) tear in this case provides an example of a Stener-type lesion.