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11b - Answer: 18-year-old male presents with pain and weakness in left wrist for two weeks

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

HISTORY: 

This 18-year-old male presents with pain and weakness in left wrist for two weeks; fell off bike.

(QUIZ ANSWER) IS A FINDING IN THIS CASE: 

All of the above.

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

FINDINGS:

A fracture in near anatomic alignment involves the midportion of the scaphoid bone with marked adjacent bone marrow edema. Bone marrow edema compatible with bone bruise involves the volar aspect of the lunate bone, the central and dorsal aspects of the capitate, and the hook of the hamate. A nondisplaced fracture involving the base of the hook of the hamate is identified. Bone marrow edema compatible with bone contusion also involves the distal dorsal and central portion of the radius and the base of the ulnar styloid. 

The flexor and extensor tendons appear intact. There is no evidence of scapholunate ligament discontinuity or joint widening. The triangular fibrocartilage appears attenuated at its radial attachment, compatible with a developmental variant. Slight positive ulnar variance is observed. 

IMPRESSION:

Left Wrist: Fracture, in near anatomic alignment, involving the midportion of the scaphoid bone with marked adjacent bone marrow edema. 

Nondisplaced fracture involving the hook of the hamate with adjacent bone bruise. 

Bone contusion involving the capitate and lunate bones. 

Subtle bone bruises involving the distal radius and ulna.

LESSON 2, TOPIC 33

Case Challenge: Wrist MRI Cases

Case Challenge

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Content reviewed: September 28, 2021

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