Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- Section 1 Shoulder
- Section 2 Arm
- Section 3 Elbow
- Section 4 Forearm
- Section 5 Wrist
- Case 32 Pseudotear of the triangular fibrocartilage (TFC): radial cartilage
- Case 33 Triangular fibrocartilage (TFC): tear versus fenestration
- Case 34 Occult carpal fractures: imaging work-up
- Case 35 Carpal instability: are you looking at a true lateral view of the wrist?
- Case 36 Extensor carpi radialis brevis and longus: synovial fluid versus tenosynovitis
- Case 37 Lunotriquetral carpal coalition: incidental finding
- Section 6 Hand
- Section 7 Hip and Pelvis
- Section 8 Thigh
- Section 9 Leg
- Section 10 Ankle
- Section 11 Foot
- Section 12 Tumors/Miscellaneous
- Index
- References
Case 36 - Extensor carpi radialis brevis and longus: synovial fluid versus tenosynovitis
from Section 5 - Wrist
Published online by Cambridge University Press: 05 July 2013
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- Section 1 Shoulder
- Section 2 Arm
- Section 3 Elbow
- Section 4 Forearm
- Section 5 Wrist
- Case 32 Pseudotear of the triangular fibrocartilage (TFC): radial cartilage
- Case 33 Triangular fibrocartilage (TFC): tear versus fenestration
- Case 34 Occult carpal fractures: imaging work-up
- Case 35 Carpal instability: are you looking at a true lateral view of the wrist?
- Case 36 Extensor carpi radialis brevis and longus: synovial fluid versus tenosynovitis
- Case 37 Lunotriquetral carpal coalition: incidental finding
- Section 6 Hand
- Section 7 Hip and Pelvis
- Section 8 Thigh
- Section 9 Leg
- Section 10 Ankle
- Section 11 Foot
- Section 12 Tumors/Miscellaneous
- Index
- References
Summary
Imaging description
Small amounts of fluid are commonly identified in the tendon sheaths of extensor tendons (Figure 36.1), particularly the extensor carpi radialis brevis and longus. The characteristic finding of the intersection syndrome on MR imaging is peritendinous edema around the first and second extensor compartment tendons, extending proximally from the crossover point.
Importance
Although the cause is unknown, fluid within the extensor tendon sheaths should not be mistaken for tenosynovitis unless the amount of fluid is excessive.
Typical clinical scenario
Tenosynovitis is an inflammatory condition that is diagnosed by noting hyperintense fluid that distends a tendon sheath and surrounds the indwelling tendon (Figure 36.2). Intersection syndrome is an inflammatory process of the second extensor compartment tendons of the forearm, characterized by pain and swelling 4–8 cm proximal to Lister’s tubercle of the distal radius.
Differential diagnosis
The main differential diagnosis is de Quervain’s tenosynovitis, which is characterized by tendinopathy and stenosing tenosynovitis affecting the abductor pollicis longus and the extensor pollicis brevis tendons and sheath.
Teaching point
Small quantities of fluid in the extensor tendon sheaths may be normal and not indicative of tenosynovitis. MR imaging can perform an important role in establishing the diagnosis of intersection syndrome of the forearm.
- Type
- Chapter
- Information
- Pearls and Pitfalls in Musculoskeletal ImagingVariants and Other Difficult Diagnoses, pp. 75 - 76Publisher: Cambridge University PressPrint publication year: 2013