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5b - Answer: 36-year-old female presents with right wrist pain

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

HISTORY: 

This 36-year-old female presents with right wrist pain, injured five months prior.

(QUIZ ANSWER) NOT A FINDING IN THIS CASE: 

Scapholunate ligament tear.

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

FINDINGS:

No recent bony macrofracture or contusion. Mild negative ulnar variance, within normal limits. Triangular fibrocartilage intact. Mild capsular inflammation around the triangular fibrocartilage. 

Carpal bones normal in alignment. Scapholunate and lunatotriquetral ligaments are intact. Extensor tendons, 1-6, intact. Mild thickening at the dorsal capsule and proximal mid carpal component with two fluid intensities; the larger one is about 1 x 2mm dorsal to the scapholunate joint space, probably capsulosynovial cyst. 

An accessory flexor digitorum superficialis indicis muscle suspected. Median nerve normal in signal intensity. No acute muscle strain. No myoedema. 

Mild contour change at 1st carpometacarpal articulation. 

CONCLUSION: 

1. No scapholunate ligament tear. 

2. Mild dorsal capsulitis at the mid carpal compartment. 

3. An accessory flexor digitorum indicis muscle. Does the patient have clinical symptom of carpal tunnel syndrome? 

4. Mild arthrosis at the 1st carpometacarpal joint.

LESSON 2, TOPIC 15

Case Challenge: Wrist MRI Cases

Case Challenge

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Content reviewed: September 28, 2021

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