Flexor carpi radialis brevis vel profundus

Case contributed by Wen Jak Ma
Diagnosis almost certain

Presentation

Persistent severe wrist pain after falling on outstretched hand.

Patient Data

Age: 75 years
Gender: Female

Incidental finding of flexor carpi radialis brevis vel profundus. The origin has not been depicted on MR. It inserts onto the distal scaphoid and capitate (a slip courses deep to FCR and FPL). There may also be insertions onto trapezium, trapezoid, second and third metacarpal bases, but these are not well seen due to the concurrent synovitis.

The radial-sided wrist is affected by advanced osteoarthrosis and synovitis. Severe synovitis extends to involve the flexor carpi radialis brevis (FCRB) secondarily.

Other coincidental findings are not described in detail here.

Annotated image

The examination with the annotated tendons or myotendinous units:

  • flexor carpi radialis brevis (FCRB) vel profundus
  • flexor carpi radialis (FCR)
  • flexor pollicis longus (FPL)

Case Discussion

Flexor carpi radialis brevis (FCRB) is a rare variant and has mostly been described in surgical literature as they were discovered during distal radial fixation. The description of origins and insertions have also been variable. 

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