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42b - Answer: 11-year-old female presents with chronic left wrist pain

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

HISTORY: 

This 11-year-old female presents with chronic left wrist pain. Patient states they fell one year prior, and landed on wrist. Still having a lot of wrist pain with weight-bearing and extension. No surgery. No injections. No cancer.

(QUIZ ANSWER) PRIMARY FINDING: 

Palmer 1 A abnormality.

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

FINDINGS: 

Ligaments: The scapholunate and lunotriquetral ligaments are normal. A central perforation of the TFC disc is present. The remaining portions of the TFCC are intact. 

Bone Marrow: No fracture is identified. Bone marrow signal appears appropriate. 

Extensor Tendons: Intact. 

Carpal Tunnel Contents: Intact. 

Soft Tissues: Intact. 

CONCLUSION: 

Central perforation of the TFC disc (Palmer classification 1A). Positive ulnar variance posture on this static exam may be amplified by conically shaped lunate creating functional abutment.

LESSON 3, TOPIC 51

Case Challenge: Wrist MRI Cases

Case Challenge

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Content reviewed: September 28, 2021

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