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Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
Continuing Medical Education (State CME)
Complete all of your state CME requirements in one convenient place.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Case Crunch: Rapid Case Review (Free)
Register for free live board reviews.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Compliance
NewTrack, fulfill, and report on all your radiologists' credentialing and licensing requirements.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Start Here
Start Here
3 topics, 3 min. of video
Practice Cases
Week 1
6 topics, 27 min. of video
Practice Cases
Week 2
7 topics, 11 min. of video
Practice Cases
Week 3
6 topics, 17 min. of video
Practice Cases
Week 4
6 topics, 15 min. of video
Practice Cases
Week 5
7 topics, 9 min. of video
End of Course Activities
Course Evaluation
1 topic
0:00
This is a 21 year old woman who is presenting with pain
0:06
and weakness of the ulnar hand on Axi
0:11
T one weighted images starting in the distal forearm,
0:14
we identified the ulnar neurovascular bundle.
0:19
We have ulnar nerve and ulnar artery. Soon enough,
0:24
there is a lipomas tumor that is causing mass effect
0:29
upon the ulnar nerve.
0:31
We can see it going into goons canal as we
0:35
approach the rest.
0:37
The landmarks for ion's canal are the PC four bone
0:42
in the proximal carpal tunnel and the hook of the hamite in
0:47
the distal carpal tunnel.
0:49
You can see this lipt tumor completely encasing the
0:54
ulnar neurovascular bundle within canal,
0:58
which is the cause of these patient's symptoms.
1:02
The patient had a history of prior surgery,
1:05
and these are ForSight of susceptibility artifact related to
1:11
surgical material within the distal aspect of guion
1:16
canal. So to summarize, lipoma tumor,
1:20
this could be related to the NAR nerve itself.
1:23
So we have ulnar lipomas or neurolipomatosis
1:28
would be in the differential diagnosis. The other conditions to,
1:33
uh, take into account would be an atypical lipomas tumor.
1:37
As this mass is, uh,
1:39
markedly ovulated with several internal, uh,
1:44
septations of, um, varying, uh, thickness, uh, which, um,
1:48
bring up, uh,
1:49
the question of this not being just a simple lipoma,
1:54
but perhaps an a typical lipoma to tumor.
1:57
So nar lip ptosis versus a typical lipoma tumor
2:02
should be in your differential diagnosis leading to
2:07
cubital tunnel syndrome or guion canal syndrome at the level of the
2:12
wrist.
Wk 2, Case 2 - Review
HIDEInteractive Transcript
0:00
This is a 21 year old woman who is presenting with pain
0:06
and weakness of the ulnar hand on Axi
0:11
T one weighted images starting in the distal forearm,
0:14
we identified the ulnar neurovascular bundle.
0:19
We have ulnar nerve and ulnar artery. Soon enough,
0:24
there is a lipomas tumor that is causing mass effect
0:29
upon the ulnar nerve.
0:31
We can see it going into goons canal as we
0:35
approach the rest.
0:37
The landmarks for ion's canal are the PC four bone
0:42
in the proximal carpal tunnel and the hook of the hamite in
0:47
the distal carpal tunnel.
0:49
You can see this lipt tumor completely encasing the
0:54
ulnar neurovascular bundle within canal,
0:58
which is the cause of these patient's symptoms.
1:02
The patient had a history of prior surgery,
1:05
and these are ForSight of susceptibility artifact related to
1:11
surgical material within the distal aspect of guion
1:16
canal. So to summarize, lipoma tumor,
1:20
this could be related to the NAR nerve itself.
1:23
So we have ulnar lipomas or neurolipomatosis
1:28
would be in the differential diagnosis. The other conditions to,
1:33
uh, take into account would be an atypical lipomas tumor.
1:37
As this mass is, uh,
1:39
markedly ovulated with several internal, uh,
1:44
septations of, um, varying, uh, thickness, uh, which, um,
1:48
bring up, uh,
1:49
the question of this not being just a simple lipoma,
1:54
but perhaps an a typical lipoma to tumor.
1:57
So nar lip ptosis versus a typical lipoma tumor
2:02
should be in your differential diagnosis leading to
2:07
cubital tunnel syndrome or guion canal syndrome at the level of the
2:12
wrist.
Report
Patient History
21-year-old female with right anterior wrist pain, weakness, tingling and numbness, which began approximately 1 month ago. No known injury. Patient has a history of prior surgery 3 years ago when she had a cyst removed.
Findings
ALIGNMENT:
Ulnar Variance: Negative ulnar posture.
Distal Radioulnar Joint: Normal.
Carpal Instability: None.
ARTICULATIONS:
Thumb Carpometacarpal Joint: Normal.
Scaphotrapeziotrapezoidal Joint: Normal.
Pisiform-Triquetral Joint: Normal.
Radiocarpal Joint: Normal.
Distal Radioulnar Joint: Normal.
Carpal Effusion: None.
Distal Radioulnar Joint Effusion: None.
INTRINSIC LIGAMENTS:
Scapholunate Ligament: Intact.
Lunotriquetral Ligament: Intact.
Triangular Fibrocartilage: Intact.
Lunate Facet: Normal.
Hamate-Lunate Facet: Normal.
Extensor Compartment: No tendinopathy or tears.
Flexor Compartment: No tendinopathy or tears.
Carpal Tunnel: No space-occupying lesions.
Median Nerve: Normal signal and diameter.
Flexor Retinaculum: No thickening or palmar bowing.
Flexor Tendons: No tendinopathy or tears.
Guyon's Canal: A 2.8 cm x 3.1 cm x 6.1 cm (AP, transverse and CC diameters) ulnar-sided encapsulated lipoma with thin internal septations is located in the palmar ulnar side of the wrist, spanning the distal forearm, wrist and down into the Guyon canal.
OTHER FINDINGS:
Skeleton: No fracture or dislocations.
Soft Tissues: Thenar and hypothenar muscles are normal without fatty infiltration or volumetric atrophy. The interossei and lumbricals are also normal.
Vessels: Normal.
Impressions
1.A large 2.8 cm x 3.1 cm x 6.1 cm encapsulated fat signal mass in the palmar, ulnar aspect spanning the distal forearm, wrist and Guyon canal, producing mass effect and compressing the superficial sensory and deep motor branches of the palmar division of the ulnar nerve. No fatty infiltration or volumetric atrophy denervation of the hypothenar, interossei and lumbrical muscles at this moment. Findings most compatible with a lipoma. Complex septations may be seen in atypical lipomatous tumors so called ALT.
Case Discussion
Faculty
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
ProScan Imaging
Jenny T Bencardino, MD
Vice-Chair, Academic Affairs Department of Radiology
Montefiore Radiology
Todd D. Greenberg, MD
Radiologist
ProScan
Tags
Musculoskeletal (MSK)
MRI
Hand & Wrist
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