Carpal tunnel syndrome and De Quervain tenosynovitis

Case contributed by Dr Bahman Rasuli

Presentation

Pain along with the radial and radial aspect of the right wrist and the history of carpal tunnel surgery two months ago on the same side.

Patient Data

Age: 40 years
Gender: Female

Abnormal intrasubstance increased fluid signal and thickening is present along the course of the first dorsal extensor compartment tendons of the wrist (abductor pollicis longus and extensor pollicis brevis ).

Peritendinous fluid signal within the first dorsal compartment also is seen related to tenosynovitis.

Loss of the continuity of the flexor retinaculum is seen in the background of post-treatment changes.

Palmar bowing of the flexor retinaculum also is seen.

Enlargement of the median nerve at the level of the pisiform and flattening at the level of the hook of hamate is present.

Edema and loss of normal fat signal within the carpal tunnel are also noted.

Synovial cyst measuring 4*7mm is noted at the medial and palmar aspect of the wrist.

Intraosseous degenerative cyst also is seen within the scaphoid bone proximal pole.

Case Discussion

In the physical examination, the recent patient also had a positive Tinel's sign and Phalen's test moreover the positive Finkelstein test.

Clinical exam in combination with the MRI findings makes the diagnosis of recurrence of carpal tunnel syndrome as well as De Quervain tenosynovitis. 

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Case information

rID: 70019
Published: 30th Jul 2019
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: Jame Jam Imaging Center

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