Presentation
The patient presents with symptoms of left carpal tunnel syndrome.
Patient Data
Flexor tendon sheath tenosynovitis involving the flexor pollicis longus and the flexor digitorum muscles (profundus and superficialis) is characterized by sheath thickening and increased signal intensity on PDFS/GRE, with intermediate signal on T2W, extending proximally from the level of the metacarpophalangeal joint to the distal third of the forearm. The median nerve shows an increased cross-sectional area of approximately 17 mm².
Both flexor and extensor tendons remain intact without evidence of tearing.
No significant joint effusion is observed at the metacarpophalangeal or interphalangeal joints.
Triangular fibrocartilage complex (TFCC) injury at the ligamentous attachment site.
Case Discussion
The imaging findings are consistent with flexor tendons tenosynovitis of the wrist with median nerve compression, resulting in carpal tunnel syndrome. A possible differential diagnosis would be a diffuse tenosynovial giant cell tumor (DTGCT).
The patient was managed with rest and wrist immobilization using a splint to reduce inflammation.
Pain relief and anti-inflammatory treatment with NSAIDs, corticosteroids, and physical therapy have helped improve symptoms and restore mobility.
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