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6b - Answer: 19-year-old male presents with pain mid dorsal right wrist

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

HISTORY: 

This 19-year-old male presents with pain mid dorsal right wrist. Injured two weeks prior. Decreased range of motion. No surgery.

(QUIZ ANSWER) IS A FINDING IN THIS CASE: 

Bony prominence at dorsal aspect of proximal 3rd metacarpal.

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

FINDINGS:

No abnormal bone marrow signal. Normal alignment throughout the wrist. No wrist joint effusion. Neutral ulnar variance posturing. No focal soft tissue edema or swelling.

No widening of the scapholunate or lunotriquetral joint spaces. SL and LT ligaments are intact. Triangular fibrocartilage intact. 

Dorsal extensor tendons intact. Volar flexor tendons intact. Carpal tunnel and median nerve unremarkable in appearance. Guyon's canal grossly unremarkable. 

No focal mass lesion or cyst at the dorsal aspect of the wrist. Mild bony bossing or prominence of the dorsal aspect of the proximal 3rd metacarpal. No abnormal marrow signal within it or surrounding adventitial fluid. Normal signal and bulk of visualized intrinsic hand muscles. 

CONCLUSION: 

1. Mild bony prominence at the dorsal aspect of the proximal 3rd metacarpal. Os styloideum/carpal boss. No edema or surrounding inflammation. No focal mass lesion at the dorsal wrist. 

2. The remainder of the wrist is unremarkable in appearance.

LESSON 2, TOPIC 18

Case Challenge: Wrist MRI Cases

Case Challenge

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Content reviewed: September 28, 2021

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