Presentation
Wrist pain and reduced range of motion. No history of trauma.
Patient Data
Lucency centered on the ulnar margin of the radial metaphysis. There is widening of the physis. Appearances are most in keeping with infection.
Follow up imaging 8 years later shows deformity centered on the distal radius. There has been development of a bony bar and growth disturbance.
The bony bar is clearly seen on this T1 weighted sequence.
Case Discussion
Metaphyseal lucency is often the result of infection and this should be actively considered. Raised inflammatory markers and systemic upset are helpful keys to making the diagnosis.
Ultrasound may demonstrate a joint effusion or subperiosteal collection. MRI is more sensitive for these findings and may also demonstrate medullary edema or reactive soft-tissue inflammatory change.
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