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4b - Answer: 14-year-old female presents with ulnar-sided left wrist pain for three weeks

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

HISTORY: 

This 14-year-old female presents with ulnar-sided left wrist pain for three weeks. Ran into a wall using her wrist to stop herself.

(QUIZ ANSWER) PINHOLE TEAR IS IN: 

Triangular fribrocartilage.

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

FINDINGS:

Although there is a small pinhole TFCC tear in the central third with inflammation in the distal radioulnar joint, a nondisplaced fracture that is not yet completely resolved involves the dorsum of the radius, is nondisplaced, and involves the metaphysis just proximal to the closing or nearly closed growth plate. 

The scapholunate ligament is intact. 

The lunatotriquetral ligament is intact. 

The extensor carpi ulnaris is intact. 

CONCLUSION: 

1. Nondisplaced intramedullary fracture of the radius likely subacute in age (weeks to months) and without displacement. 

2. Small pinhole tear in the central third of the TFC with inflammation in the distal radioulnar articulation.

LESSON 2, TOPIC 12

Case Challenge: Wrist MRI Cases

Case Challenge

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Content reviewed: September 28, 2021

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