23b - Answer: 57-year-old male presents with right wrist pain
HISTORY:
This 57-year-old male presents with right wrist pain.
(QUIZ ANSWER) IS A FINDING IN THIS CASE:
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:
Middle and inner thirds of the triangular fibrocartilage are completely torn. Peripheral attachment TFCC synovitis is noted. Gadolinium extends from the proximal carpal row into the DRUJ.
Scapholunate and lunatotriquetral ligaments are intact. No widening of the scapholunate interval.
Regions of patchy stress injury are throughout the proximal and distal carpal row. No macrofracture.
Flexor and extensor tendon complexes are intact. Tendinosis within the extensor carpi ulnaris tendon is present. No macrotear.
Complex capsulosynovitis includes synovial thickening and proliferation.
No soft tissue mass.
IMPRESSION:
Complete triangular fibrocartilage tear associated with mild ulnocarpal arthropathy and small osteochondral erosions within distal aspect of the ulna and proximal lunate. Mild stress injury is associated.
Regions of patchy stress injury throughout the carpus. No macrofracture.
Complex capsulosynovitis. Diffuse synovial thickening and proliferation is present for which the sequela of an inflammatory arthropathy such as rheumatoid, gout or pseudogout are possibilities.
Low grade ECU tendinosis without macrotear.
Case Challenge: Wrist MRI Cases
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Content reviewed: September 28, 2021