Posts Categorized: Wrist

A wrist’s tale: When pain met swelling

This 15-year-old female presents with anterior right wrist pain and swelling. There is no known injury or prior surgery. Have a look at images 1 through 6, and see if you can answer the following questions. Q1 – What is the most likely diagnosis in this 15-year-old female with a mass of the volar aspect… Read more »

They in’cyst’ed that we have a histological review

This 62-year-old female presents with a left wrist mass that has recurred five times after two prior drainages and two prior surgical removals. Images 1 and 2 are in the short-axis view. Based on image 1 (a proton-density non-fat-suppressed image), and image 2 (a T2 fast spin-echo image with fat suppression): Q1 – What is… Read more »

While observing the mass, we noticed she had a tail

This 44-year-old female presents with right wrist pain. You are shown five images. A coronal proton density (image 1), a coronal proton density fat suppression (image 2), two sagittal proton density fat suppression (images 3 and 4), and an axial or short-axis proton density (image 5). A hyperintense mass around the ulna is obvious. Q1 –… Read more »

Anatomy is king (or queen) in this wrist case

This 45-year-old male has pain around the scaphoid after an accident. Q1 – What is wrong with the scaphoid? On the two water-weighted images (image 1, proton density fat suppression; image 2, three-dimensional additive gradient echo or ADAGE), attempt to identify the structures labeled red, blue and green. This is a real challenge unless you… Read more »

How does this 61-year-old’s wrist diagnosis differ from a young athlete’s?

This 61-year-old male has wrist pain. What is the clinical diagnosis based on MRI? What is the most common symptomatic extensor compartment in a 61-year-old? What is the most common symptomatic extensor compartment for a 25-year-old active person? The diagnosis in this case is hypertrophic tendinopathy and peritendinitis of the extensor pollicis brevis and abductor… Read more »

You recognize the wrist lesion, but what is its typical location?

This is a 15-year-old female with a dorsal soft tissue mass. You are shown two images, a short-axis T1-weighted spin echo (image 1) and a short-axis T2-weighted spin echo image (image 2). There really is not a differential diagnosis. So a more challenging question is: where does such a lesion normally occur in the wrist?… Read more »

What is the unusual anatomic variant in this wrist case?

This 29-year-old male presented with a traumatic injury of the left palmar wrist. What anatomic variant seen in this patient must be taken into account? Ulnar-sided pain in this case can be attributed to: ECU tenosynovitis, tendinosis, and longitudinal partial-thickness tearing (images 3 and 4, arrows). ECU subsheath inflammation (horizontal arrow-image 3). Peripheral TFCC attachment… Read more »