Extensor carpi radialis longus tendinosis (orthopedic hardware impingement)

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

History of intramedullary nail fixation for the radius shaft fracture about 1 year back. Complaining of swelling with mild pain on the dorsal radial side of the wrist.

Patient Data

Age: 45 years
Gender: Female

The extensor carpi radialis longus tendon is intact. It shows thickening and hypoechoic areas. With wrist flexion, the tendon is impinged by the radius intramedullary nail tip. The tendon sheath shows thickening without effusion/ hypervascularity. There is a reverberation artifact due to the radius nail.

Extensor carpi radialis brevis tendon is intact with normal echopattern. It is not impinged by the radius nail tip. There is no tenosynovitis.

The rest of the dorsal wrist examination was normal.

Case Discussion

The case shows extensor carpi radialis longus tendinosis due to impingement caused by an intramedullary nail.

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