Presentation
Pain and swelling at dorsal aspect of wrist.
Patient Data
Significant fluid with areas of synovial thickening is seen along the tendons of 4th extensor compartment causing distention of common sheath. This is extending from approx. 60mm proximal to wrist joint upto mid shaft of metacarpals.
Flexor tendons and rest of extensor tendons are unremarkable.
Alignment of bones appears normal.
Carpal bones, visualized part of distal radius and ulna and proximal metacarpal bones appear normal.
Radiocarpal, ulnocarpal, intercarpal and carpometacarpal joints appear normal with no evidence of significant joint effusion.
Carpal tunnel appears normal.
The last image stack of of the contralateral (right) wrist which does not show any synovitis or tenosynovitis.
Case Discussion
Above findings are suggestive of tenosynovitis of 4th extensor compartment of wrist. In view of unilateral involvement and areas of significant synovial thickening, an infective etiology is plausible.
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