Presentation
Chronic pain and swelling at the volar wrist and a positive serum rheumatoid factor.
Patient Data
Tenosynovitis of the flexor pollicis longus and flexor digitorum tendons includes numerous T2 hypointense foci (rice bodies) from the level of the metacarpophalangeal joint with upward extension up to the level of the distal third of the forearm.
Both flexor and extensor tendons are intact without a tear.
There is no effusion in the metacarpophalangeal joint or interphalangeal joints.
Synovial cyst measuring about 8 x14 mm originating from the joint space between the triquetrum and pisiform bones on the ulnar side of the wrist.
TFCC foveal cyst measuring about 5 x10 mm on the ulnar side.
Case Discussion
The recent patient referred to us with the history of chronic hand and wrist pain and swelling for one year ago without obvious trauma. Regarding the MRI imaging findings and positive rheumatoid factor, inflammatory arthritis could be the underlying cause of flexor tendons tenosynovitis. Flexor digitorum tenosynovitis is the most frequent cause of carpal tunnel syndrome and also an early indicator of rheumatoid arthritis.
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