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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
These are on 42 year old patient who has wrist pain.
0:06
There are many findings going on. These images,
0:10
we're gonna concentrate on the presence. Ofid,
0:14
trap trapezoid, osteoarthritis also turn
0:21
osteoarthritis. In assessing the articulation,
0:25
we can see complete loss of articular cartilage overlying the subc
0:30
plates at the opposing articulating surfaces of the distal
0:37
trapezium and trapezoid bones, bone on bone contact,
0:42
subcon, cystic changes, reactive edema,
0:46
and on T one weighted images.
0:48
We can also see a small marginal osteophytes right here
0:53
on the radial side of the scaphoid
0:58
trapezoid articulation. In addition,
1:02
this patient has other internal arrangements of the rest,
1:07
including SK four lunate ligament sprain,
1:10
particularly involving the dorsal fibers,
1:13
which may be a contributing factor for the development of early
1:18
osteoarthritis in this patient.
1:20
There were also findings on the side of the.
Wk 3, Case 3 - Review
HIDEInteractive Transcript
0:00
These are on 42 year old patient who has wrist pain.
0:06
There are many findings going on. These images,
0:10
we're gonna concentrate on the presence. Ofid,
0:14
trap trapezoid, osteoarthritis also turn
0:21
osteoarthritis. In assessing the articulation,
0:25
we can see complete loss of articular cartilage overlying the subc
0:30
plates at the opposing articulating surfaces of the distal
0:37
trapezium and trapezoid bones, bone on bone contact,
0:42
subcon, cystic changes, reactive edema,
0:46
and on T one weighted images.
0:48
We can also see a small marginal osteophytes right here
0:53
on the radial side of the scaphoid
0:58
trapezoid articulation. In addition,
1:02
this patient has other internal arrangements of the rest,
1:07
including SK four lunate ligament sprain,
1:10
particularly involving the dorsal fibers,
1:13
which may be a contributing factor for the development of early
1:18
osteoarthritis in this patient.
1:20
There were also findings on the side of the.
Report
Patient History
42-year-old male with right wrist pain with using wrist neutral or with any motion.
Findings
ALIGNMENT:
Ulnar Variance: Slightly positive.
Distal Radioulnar Joint: Incongruence of the distal radioulnar joint with dorsal and lateral tilting of the distal ulna which does not articulate with the sigmoid notch of the radius.
Carpal Instability: Dorsal tilting of the lunate.
ARTICULATIONS:
Thumb Carpometacarpal Joint: Mild osteoarthritis and chondromalacia with penetrating chondral fissures and intraosseous ganglion cysts within the hamate.
Scaphotrapeziotrapezoidal Joint: Moderate arthrosis and class 4 chondromalacia.
Pisiform-Triquetral Joint: Mild osteoarthritis.
Radiocarpal Joint: Normal.
Distal Radioulnar Joint: Moderate effusion of the distal radioulnar joint.
Carpal Effusion: Trace.
INTRINSIC LIGAMENTS:
Scapholunate Ligament: Swelling and nonconspicuity of the dorsal band of the scapholunate ligament and mild diastasis measuring up to 2mm in diameter.
Lunotriquetral Ligament: Normal.
Triangular Fibrocartilage: Central perforation of the disc proper. Diffuse swelling throughout the foveal and ulnar attachments of the triangular ligament.
Lunate Facet: Chondromalacia throughout the lunate with intraosseous ganglions at the level of the ulnocarpal joint.
Hamate-Lunate Facet: Normal.
Extensor Compartment: Short-segment diminutive split tear of the extensor carpi ulnaris, a few millimeters beyond the ulnar styloid and measuring up to 1cm in length. The rest of the extensor compartments are intact.
Flexor Compartment: Normal.
Carpal Tunnel: No space-occupying lesions.
Median Nerve: Normal signal. Vertical median nerve orientation as a variation between the flexor pollicis and flexor indicis.
Flexor Retinaculum: No thickening or scarring
Flexor Tendons: Normal.
Guyon's Canal: Normal.
OTHER FINDINGS:
Skeleton: No acute fractures or osteoedema.
Soft Tissues: No space-occupying lesions.
Vessels: Normal neurovascular bundles.
Impressions
1.Moderate scaphotrapezoidtrapezoidal joint osteoarthrosis with grade 4 chondromalacia and subchondral arthropathic cysts.
2.Dorsal radioulnar instability with subluxation and tearing of the dorsal radioulnar ligament.
3.A 1cm longitudinal split tear of the extensor carpi ulnaris, a few millimeters beyond the ulnar styloid.
4.Central perforation of the TFCC disc proper resulting in a small effusion of the distal radioulnar joint. Associated lunate chondromalacia. The findings are in keeping with a Palmer class 2C TFCC injury. Associated swelling of the triangular ligament.
5.Derangement of the dorsal scapholunate ligament resulting in 2mm diastasis and dorsal intercalated segmental instability (DISI).
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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