Wrist Case 1

Clinical History:

M57 with on-going volar aspect pain & swelling over FCR tendon & STT joint 4 months after injury.

Imaging:

REVEAL DIAGNOSIS

Diagnosis:

FCR tendontis, partial-thickness tendon tear and tenosynovitis secondary to SST joint arthrosis

Discussion:

Ultrasound shows:

  1. FCR ‘tendonitis’ appreciated as fusiform hypoechoic tendon swelling at scaphoid level with associated hyperaemia (yellow arrow);
  2. Superimposed shallow partial-thickness tear of FCR tendon appreciated as an abrupt focal hypoechoic interruption in fibre continuity with associated tendon contour change at the deep surface (white arrow);
  3. Predisposing osteoarthrosis at the adjacent STT joint appreciated as a roughened volar articular margin of distal pole scaphoid and accompanying small subchondral cyst (white arrowhead); and
  4. Associated chronic FCR tenosynovitis appreciated as thickened tenosynovium (yellow arrowheads) and peritendon hyperaemia (Power Doppler).
NOTE:  scaph = scaphoid, rad = radius