47F chronic painful wrist mass x 4 years, MRI, please help

Dear all,Attached surgically proven case of Marinum in an immunocompromised local Dr who a few weeks prior went scuba diving in Fiji and denied any penetrating injury.
No synovitis elsewhere (extensor tendons of the same wrist), other wrist totally normal, also ankles, feet, which made me think of subacute atypical infection.
best wishes
GK

On Wed, 13 Nov 2024 at 03:14, hilary umans <hilary.umans> wrote:

Andy Sonin suggests we should call these large ones Risotto Bodies….anyone second the motion?

Julio Brandao shared his case report with similar imaging findings.
It’s a great reminder that fungus can always look like mycobacterial infection.

On Mon, Nov 11, 2024 at 12:38 PM hilary umans <hilary.umans> wrote:

This case is a consult from my colleague Greg Wilde. There is only one clinic note available to review and some reported history of rheumatoid arthritis, though we don’t have any additional imaging or treatment history

The joint spaces and osseous alignment appear preserved without marrow signal alteration or erosions

No hemosiderin effect

Synovial thickening and enhancement, though the nodules do not enhance…which is confusing if the nodules are synovial….
even with synovial osteochondromatosis, usually you see synovial enhancement at the periphery of the nodular bodies

Not at all sure what to call this…..please help….the report is not yet finalized.

Thank you.

Hilary

Loading

Leave a Comment