36b - Answer: 14-year-old female presents with mild to moderate, constant dull pain in right wrist
HISTORY:
This 14-year-old female presents with mild to moderate, constant dull pain in right wrist since a track injury eight months prior. History of broken wrists. Difficulty applying pressure and throwing. Weakness.
(QUIZ ANSWER) PRIMARY FINDING:
Palmer 2 B abnormality.
Using the diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.
FINDINGS:
Triangular fibrocartilage and peripheral attachments are intact. TFC thinned and slightly edematous, Palmer 2B. Ulnar positive variance. Physes are open.
Regions of subcortical stress marrow reaction/microfracturing ulnar aspect of the lunate. No macrofracture. No AVN.
Intact intrinsic ligaments.
Flexor and extensor tendon complexes are intact.
Mild swelling within the ulnar bursa. Flat ganglion cyst ventral to the distal radius.
No soft tissue mass.
IMPRESSION:
Right Wrist: Regions of subcortical stress microfracturing favored over the sequelae of an impaction injury ulnar aspect of the lunate. Associated ulnar positive variance without TFC tear or AVN. But TFC thinned and slightly edematous, Palmer 2B.
Capsulitis. Ventral capsular swelling and mild ulnar bursal swelling.
Case Challenge: Wrist MRI Cases
Case Challenge
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Content reviewed: September 28, 2021