Flexor tendons tenosynovitis - wrist

Case contributed by Dr Bahman Rasuli

Presentation

Chronic pain and swelling at the volar wrist and a positive serum rheumatoid factor.

Patient Data

Age: 25 years
Gender: Male

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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Case information

rID: 69391
Published: 15th Jul 2019
Last edited: 17th Jul 2019
Inclusion in quiz mode: Included
Institution: Jame Jam Imaging Center

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