pseudotumoral soft tissue lesions of the hand and wrist

Pseudotumoural

soft tissue lesions of the hand and wrist: a pictorial review. Extensor carpi ulnaris tenosynovitis. Axial FS T2-WI shows fragmentation into multiple tendon fragments of the extensor carpi ulnaris tendon (arrowheads). Note increased fluid and debris within the tendon sheath

Pseudotumoural

soft tissue lesions of the hand and wrist: a pictorial review. Bizarre parosteal osteochondromatous proliferation (Nora’s lesion). a Plain radiograph of the finger showing a turret exostosis at the dorsal aspect of the proximal phalanx of the second finger (arrowhead). b Longitudinal ultrasound shows the exostosis causing focal contour deformity of the cortical bone (arrowheads) with adjacent hypoechoic cartilage cap (callipers)

Pseudotumoural

soft tissue lesions of the hand and wrist: a pictorial review. Examples of pseudomasses due to metabolic diseases. a Clinical picture of tophaceous gout. Peri-articular soft-tissue swelling best seen at the proximal interphalangeal joint of the third finger. b Corresponding plain radiograph showing soft-tissue swelling and adjacent periosteal new bone formation (arrow). c Ultrasound of another patient with tophaceous gout at the metacarpophalangeal joint of the thumb, showing a hypoechoic mass with intralesional reflections with retro-acoustic shadowing due to monosodium urate crystal deposition (arrows). d Pseudogout (hydroxyapatite deposition disease) in another patient. Plain radiograph showing linear and amorphous calcifications at the joint capsule of the distal interphalangeal joint of the index (arrows)

Pseudotumoural

soft tissue lesions of the hand and wrist: a pictorial review. Hypothenar hammer syndrome. a Sagittal SE T1-WI shows a hypointense lesion superficial to the flexor tendons (arrowhead) and immediately distal to the hamulus of the hamate (asterisk). b Axial FS SE T1-WI after intravenous administration of gadolinium contrast medium shows focal aneurysmal dilatation of the ulnar artery with central thrombosis (arrow). Note only faint peripheral enhancement. c Doppler ultrasound shows intraluminal thrombosis of the aneurysm of the ulnar artery. d MR angiography shows multiple stenoses at the distal ulnar artery with aneurysmal dilatation with internal clot formation (arrow)

Pseudotumoural

soft tissue lesions of the hand and wrist: a pictorial review. Histopathologically proven rheumatoid nodule in a patient with known rheumatoid arthritis. a Coronal SE T1-WI. Hypointense subcutaneous nodule at the palmar aspect of the distal phalanx of the right digit 3 (arrowheads). b Sagittal FS TSE T2-WI. High signal intensity of the lesion (black arrows). There is moderate pressure erosion of the palmar aspect of the distal phalanx. c Sagittal FS SE T1-WI after intravenous injection of gadolinium contrast medium. There is peripheral enhancement of the lesion (black arrowheads). Palmar localisation of a rheumatoid nodule is less frequent than localisation at the dorsal aspect of the hand

Pseudotumoural

soft tissue lesions of the hand and wrist: a pictorial review. Inflammatory tenosynovitis in a patient with known rheumatoid arthritis. a Transverse ultrasound of the extensor tendons of the wrist showing fluid surrounding the extensor tendons 4. b Transverse power Doppler examination shows increased vascularity within the tendon sheath and tendons

Pseudotumoural

soft tissue lesions of the hand and wrist: a pictorial review. Subcutaneous epidermoid cyst at the phalanges (arrowheads). Longitudinal ultrasound showing a well-defined subcutaneous lesion with variable echogenicity (anechoic components and some internal hyperechoic debris)

Pseudotumoural

soft tissue lesions of the hand and wrist: a pictorial review. Subcutaneous epidermoid cyst with involvement of the adjacent bone of the terminal phalanx of the right fifth finger. a Plain radiograph showing a well-defined osteolytic defect at the radial side of the distal phalanx. Note cortical destruction of the radial cortex. b Coronal SE T1-WI. The lesion is of intermediate signal intensity (arrows) with some internal areas of relatively high signal. c Coronal TSE T2-WI. High signal intensity of the lesion (arrows). d Coronal FS SE T1-WI after intravenous injection of gadolinium contrast medium. There is only subtle peripheral enhancement (arrows) of the lesion

Pseudotumoural

soft tissue lesions of the hand and wrist: a pictorial review. De Quervain tenosynovitis. a Plain radiograph showing a non-specific soft tissue swelling at the radial styloid process (arrow). b Transverse ultrasound showing fluid surrounding the extensor pollicis brevis and abductor pollicis longus. c Longitudinal power Doppler examination shows increased vascularity surrounding the tendons