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9b - Answer: 13-year-old male presents with moderate right wrist pain

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

HISTORY: 

This 13-year-old male presents with moderate right wrist pain, worse with bending hand back. History of injury to wrist, fracture four months ago.

(QUIZ ANSWER) NOT A FINDING IN THIS CASE: 

Tearing of extensor tendon II.

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

FINDINGS:

Microtrabecular contusion of the metaphysis of the ulna. The dorsal aspect of the physis slightly widened. Triangular fibrocartilage intact. 

A nondisplaced fracture of the hamate hook. Microtrabecular contusion of the pisiform. Spotty osteoedema of the remaining carpal bones and bases of metacarpals. 

Extensor tendons I-VI intact. Flexor tendons intact. Median nerve normal in caliber. 

No acute muscle strain. 

IMPRESSION:

Right Wrist: Nondisplaced hamate hook fracture. 

Microtrabecular Salter-Harris I injury of distal ulna. 

Scattered spotty osteoedema of the carpal bones consistent with overuse. Microtrabecular contusion of the pisiform.

LESSON 2, TOPIC 27

Case Challenge: Wrist MRI Cases

Case Challenge

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Content reviewed: September 28, 2021

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