Case Review: Young Patient with Thumb Injury on MRI
Channel: MRI Online Powered by Medality
Date: 2020-03-08

MRI Mastery Series: Thumb & Finger, presented by Dr. Stephen Pomeranz, MD
https://mrionline.com/p/thumb-mri/

If you’re lucky, you have eight fingers and two thumbs that perform innumerable tasks for you – and along the way they can get caught, popped, crushed, locked, punctured, jammed or bent in ways that are just plain wrong. Between them they encompass 30 separate joints which are largely similar to one another, aiding in diagnosis, but as any extremity surgeon will tell you the gamut of clinical presentations is surprising and can be confounding. 

We’re not just talking avulsion fractures, glomus tumors and subcutaneous tissue incursions.
These surgeons and specialists, like the baristas in your local coffee shop, have their own language to describe the variations – trigger injuries, beak ligaments, boutonniere deformities, pulley mechanisms – and they expect you to speak their language. The anatomy of your distal upper extremities lends itself to interesting descriptions, and the appearances on MRI can be memorable – just seeing a wide range of finger/thumb imaging can “trigger” your memory and make many of the mnemonics second nature. So how do you get to see as much “digital” MRI as possible?

We were hoping you’d ask! Our Thumb & Finger MRI Mastery anatomy series thoroughly explores volar and dorsal, extensor and flexor, brevis and longus, abductors and adductors, and those pesky sesamoids. This is followed by case reviews of patients ranging in age from 15 to 78 who’ve had run-ins with sports equipment, power tools, leashes, and mystery masses. 

If you’re still hungry for more, we have supplementary advanced Orthopaedic Joint Series and Professional Series resources to round out your tour of the MCPs, PIPs and DIPs. We have had the good fortune to participate in quarterly hand and wrist conferences with our surgical colleagues for many years, so we can also share some insights into postsurgical evaluation and possible follow up and treatment options. Finger “tips” at your fingertips and “pointers” on which relevant thumbnails will give you the most useful views – your referring clinicians will appreciate your decision to take advantage of our case experience!

Thumb & Finger MRI Anatomy & Diganosis Covered in this Course

* Abductor pollicis longus
* Adductors
* Boxer’s knuckle
* Carpometacarpal (CMC) joint: Dorsal ligaments
* Carpometacarpal (CMC) joint: Volar ligaments
* Dorsal plates
* Extensor pollicis brevis
* Extensor pollicis longus
* Fall on an outstretched hand (FOOSH)
* Flexor pollicis longus
* Gamekeeper thumb
* Glomus Tumor
* Infections
* Masses (e.g. glomus tumor)
* Pulleys
* Radial collateral ligament (RCL) tear
* Radial collateral ligaments (RCL)
* Sesamoids
* Stener lesions
* Thenar muscles: Abductor pollicis brevis
* Thenar muscles: Abductor pollicis longus
* Ulnar collateral ligament (UCL) tear
* Ulnar collateral ligaments (UCL)
* Volar plates
* And much more…

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