Dr. Benjamin Eyer discusses the utility of MRI in the evaluation of an under-appreciated cause of wrist pain.
Wrist Ganglion Cysts
A 22 year-old woman first noted a painless lump on the dorsum of her wrist a few months ago. It aches when the wrist is extended and weightbearing, such as when doing a “plank” during yoga. On exam, the mass feels firm and partly mobile. Axial T1-weighted (1a) and fat-suppressed PD-weighted (1b), coronal fat-suppressed PD-weighted (1c), and sagittal T2-weighted (1d) images are shown.
Displaced Triangular Fibrocartilage Cartilage Complex Tears
A 25-year-old female presents with dorsal ulnar sided wrist pain, four weeks after a fall. Coronal (1A) and axial (1B) fat-suppressed proton density-weighted images and a (1C) T2-weighted sagittal image are provided.
Pigmented Villonodular Synovitis
A 21 year-old female complains of pain, swelling, and stiffness in the knee anteriorly, status post MVA 4 months ago. (1A,1B,1C) Sagittal STIR, T1-weighted, and gradient echo sequences are provided.
Scapholunate Instability – An Update
A 41-year-old right-handed man presents with 3 years of radial-sided right wrist pain. No specific injury, but he began having severe wrist pain while training for the marines. He was initially treated with rest, which resulted in improved symptoms. The symptoms were aggravated while working out….
Dupuytren’s Disease
In this month’s Radsource MRI Web Clinic, Dr. David Rubin discusses the role of MRI in the evaluation of a characteristic entity that affects the fingers.
Collateral Ligament Injuries of the Fingers
A 16 year-old male presents for MRI of the hand following a wrestling injury with pain at the metacarpal-phalangeal joint (MPJ) of the small finger. Consecutive (1A) fat-suppressed T2-weighted images of the small finger MPJ from dorsal to palmar and a (1B) single fat-suppressed proton density-weighted axial image are provided.
Guyon’s Canal
A 43-year-old male presents with numbness and tingling along the ring and small finger for 6 weeks with decreased grip strength? Axial fat-suppressed T2-weighted (1A,B) and coronal fat-suppressed T2 (1C) and T1 weighted (1D) images are provided.
Persistent Median Artery
A 35 year-old male patient presents with index finger ischemia and volar wrist pain. Fat-suppressed proton density-weighted axial (1a-c) and sagittal T2-weighted (1d) images through the wrist near the level of the carpal tunnel are provided.
Extensor Pollicis Longus Rupture
A 43 year-old male presents with pain for 3 days after injury. He is experiencing forearm cramping and is unable to extend his thumb.
Foreign Body Imaging with MRI
In this month’s Radsource MRI Web Clinic, Drs. Leon Toye and Anthony Onofrio discuss an entity that may present diagnostic challenges in a variety of musculoskeletal locations.
Traumatic Neuroma
A 45 year old man fell through a plate glass window 6 months ago, lacerating the right wrist with subsequent diminished sensation in the right thumb, index and middle fingers. He now presents to the orthopaedist with an enlarging painful mass in the wrist at the site of injury.
The Thumb Carpometacarpal Joint
A 21 year-old male crashed his all-terrain vehicle 10 days ago and radiographs revealed dorsoradial dislocation of the thumb CMC joint. Coronal STIR images of the wrist/thumb are provided.
MR Imaging of Rheumatoid Arthritis
A 47 year-old woman presents with polyarthralgias and morning stiffness.
Ulnar Collateral Ligament Tears of the Thumb
A 16 year-old male presents with pain and laxity at the thumb metacarpophalangeal joint after a fall onto his right hand 12 days prior to the MRI examination.
Accessory Muscles of the Hand and Wrist
Clinical history: A 29 year-old female presents with increasing swelling of the volar 1st web space for several years. She has numbness in the thumb and pain with gripping. Proton density-weighted (1a) and STIR (1b) axial images and T1-weighted sagittal (1c) and...
Palmar Bursae and Flexor Tendon Sheaths of the Wrist and Hand
Clinical History: A 55-year-old man developed slowly progressive swelling of the right hand and wrist over the previous several months. Fat-suppressed T2-weighted axial image just proximal to the wrist (1a) and fat-suppressed T1-weighted post-contrast axial images at...
Tendon Intersection Syndromes
Case 1 A 43 year old female presents with radial side forearm pain after working in her garden for several days. MRI was obtained with axial fat-suppressed fast spin-echo T2-weighted (1a) and coronal inversion recovery-weighted (1b) images. ...
Carpal Instability
Clinical History: A 45 year-old woman with a history of arthritis presents with progressive wrist pain. Fat-suppressed proton density-weighted axial (1a), fat-suppressed T2-weighted coronal (1b), and proton density-weighted sagittal (1c,1d) images are provided. What...
Flexor Tendon Injuries
Clinical History: A 16 year-old male presents with loss of flexion at the distal interphalangeal joint (DIP) of the ring finger, following an injury playing flag football 2 weeks before. T1-weighted axial (1a), fat-suppressed proton density-weighted axial (1b), and...
Upper Extremity Sports Injuries
Clinical History: Images from four different upper extremity sports injuries are presented. Match each patient with the associated sport. A) Boxing B) Gymnastics C) Golf D) Bowling Case 1: Case 2: Case 3: [figure...
SLL Tear and DISI Deformity
Clinical History: Each of two patients presents with wrist pain. What are the findings in relation to the scapholunate ligament? Which patient has the more significant abnormality? Patient 1. Patient 2. Findings Patient 1. 1. Incomplete...
Extensor Carpi Ulnaris Subsheath Injury
Clinical History: A 44 year old recreational tennis player complains of chronic, worsening ulnar sided wrist pain. (1a) Gradient echo coronal, (1b) T1-weighted axial, and (1c) STIR axial images of the wrist are provided. What are the findings? What is your diagnosis?...
Hypothenar Hammer Syndrome
Clinical History: A 35 year old male carpenter presents with pain in the hypothenar region of the right hand and ischemia in the third, fourth and fifth fingers. (1a) An axial T1-weighted image and (1b) a coronal plane maximal intensity projection (MIP) image from a...
Ulnocarpal Abutment
Clinical History: A 62 year old female presents with an 11 month history of ulnar sided wrist pain, swelling, and limited range of motion. (1a) Gradient echo and (1b) T1-weighted coronal images are provided. What are the findings" What is your diagnosis? [figure...
Silicone Synovitis
Clinical History: A 64 year-old female underwent a surgical procedure on her left ankle approximately 40 years ago. She now presents with pain and swelling. A sagittal T1-weighted image (1a) and a coronal proton-density, fat suppressed image (1b) are provided. What...
Fingertip Lesions
Clinical History: A 50 year-old female presents with pain along the ulnar side of her distal long finger. (1a) Proton-density weighted coronal, (1b) STIR coronal and (1c) contrast-enhanced fat-suppressed T1-weighted axial images are provided. What are the findings?...
Extensor Tendon Injuries of the Finger
Clinical History: A 39 year-old female who cut her long finger on a tuna can presents with pain and limited extension at the MCP joint. Sagittal T1 (1a) and axial proton-density fat-suppressed (2a) images are provided. What are the findings" What is your diagnosis?...
Scaphoid Fracture
Clinical History: A 28 year-old male with a history of scaphoid fracture presents with persistent wrist pain despite four months of casting. A T1-weighted coronal image (1a) is provided. What are the findings? What is your diagnosis? Findings [figure...
Pulley Lesion of the Fingers
Clinical History: A 28 year-old rock climber presents with persistent pain and swelling at the index finger. (1a) A T2-weighted sagittal image with fat-suppression and (1b) a proton density-weighted fat-suppressed axial image are provided. What are the findings" What...
Triangular Fibrocartilage Tear
Clinical History: A 35 year-old female presents with ulnar-sided wrist pain. (1a) A fat-suppressed T2-weighted 3D gradient-echo coronal image is provided. What are the findings? What is your diagnosis? Findings Diagnosis Complex tear of...
De Quervain’s Tenosynovitis
Clinical History: Dorsoradial wrist pain in a 50 year-old golfer. Axial (1a) fat-suppressed proton density and (1b) T1-weighted images through the distal radius are provided. What are the findings? What is your diagnosis? Findings [figure...
Ulnar Collateral Ligament Tear of Thumb (and Stener Lesion)
Clinical history: 28 year-old female who fell while skiing. An inversion recovery coronal image centered at the thumb metacarpophalangeal joint is provided. What is your diagnosis? Findings Diagnosis Acute ulnar collateral ligament tear...
Kienbock’s Disease
Clinical History: 32 year-old construction worker with persistent wrist pain. A gradient-echo coronal MR image of the wrist is provided below (1a). What are the findings? What is your diagnosis? Answer Findings...
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