20b - Answer: 50-year-old female presents with left wrist pain since feeling a pop
HISTORY:
This 50-year-old female presents with left wrist pain since feeling a pop while pulling a patient at work.
(QUIZ ANSWER) NOT A FINDING IN THIS CASE:
Moderate triangular fibrocartilage tear.
Using the diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.
FINDINGS:
The bones are in anatomic alignment. The bone marrow signal is normal without evidence of occult fracture, stress fracture or bone contusion. Arthropathic changes of the lunate and triquetrum are noted consistent with mild lunatotriquetromalacia, thinned TFC and small tear ulnolunate abutment Palmar IIC. An arthropathic pseudocyst is identified within the capitate. Mild dorsal capsulitis noted.
The scapholunate and lunatotriquetral ligaments are intact. The triangular fibrocartilage is intact. No TFC tear. Moderate inflammation and swelling about the meniscal homologue concerning for contusion.
Moderate ECU tendinosis and tenosynovitis noted at the level of the styloid process of the ulna. The remaining extensor tendons are without abnormality. The flexor tendons are intact.
The carpal tunnel is preserved. No evidence of bulging. The median nerve is normal in caliber and signal intensity. No evidence of nerve entrapment.
The visualized muscles are intact without evidence of hemorrhage, tear or strain.
A small cystic lesion is identified extending volarly from the radioscaphoid articulation consistent with a capsulobursal cyst.
No subcutaneous edema or swelling.
CONCLUSION:
1. Contusion of the meniscal homologue. No TFC tear.
2. Moderate ECU tendinosis and tenosynovitis noted at the level of the styloid process of the ulna.
3. Volar capsulobursal cyst extending from the radioscaphoid articulation.
4. Mild lunatotriquetromalacia, thinned TFC and small tear ulnolunate abutment Palmar IIC.
Case Challenge: Wrist MRI Cases
Case Challenge
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Content reviewed: September 28, 2021