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50b - Answer: 39-year-old male presents with left wrist pain since injury seven months prior

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

HISTORY: 

This 39-year-old male presents with left wrist pain since injury seven months prior.

(QUIZ ANSWER) PRIMARY FINDING: 

Partial coalition of the trapezoid and trapezium.

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

FINDINGS: 

The trapezoid and trapezium are partially fused inferiorly consistent with coalition. Arthropathic changes are noted within the hamate and capitate. No evidence of occult fracture, stress fracture or bone contusion.

Mild dorsal capsular inflammation seen.

The scapholunate and lunatotriquetral ligaments are intact. The triangular fibrocartilage is intact. No TFC tear.

The extensor and flexor tendons are without abnormality. No tendinopathy or tear.

The median nerve is normal in caliber and signal intensity. No evidence of entrapment.

The flexor retinaculum is preserved. No bowing seen.

The visualized muscles are intact. No hemorrhage, tear or strain.

No soft tissue mass.

No subcutaneous edema or swelling seen.

CONCLUSION:

1. Partial coalition of the trapezoid and trapezium.

2. Arthropathic changes of the capitate and hamate.

3. No TFC tear.

4. Mild dorsal capsular inflammation / sprain.

LESSON 3, TOPIC 75

Case Challenge: Wrist MRI Cases

Case Challenge

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Content reviewed: September 28, 2021

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