SIRS, bacteremia. Presence of effusion? Concern for septic arthritis. A marker was placed along the dorsal aspect of the wrist. There is reticulation of the subcutaneous fat of the dorsal aspect of the wrist, and to lesser degree the volar aspect of the wrist, indicating edema. I see no discrete fluid collection within the subcutaneous tissues to suggest an abscess.A small amount of fluid is present within the dorsal recesses of the radiocarpal and midcarpal joints, and there is thin synovial enhancement within these compartments and to a lesser degree within the distal radioulnar joint. Small low signal intensity defects are noted within multiple carpal bones on the T1-weighted images, some of which show mild enhancement following gadolinium administration; however, I see no frank edema within any of the carpal bones. There is mild enhancement surrounding the flexor tendons within the distal forearm and carpal tunnel suggesting additional inflammation. The extensor tendons are unremarkable. There is mild enhancement of the synovium of the first carpometacarpal joint which is nonspecific and could be degenerative in etiology.Please note that this study was not protocoled for detailed evaluation of the small intrinsic structures of the wrist, but I see no specific findings to suggest a tear of the scapholunate lunotriquetral ligaments. Intermediate signal intensity within the triangular fibrocartilage likely reflects tearing near its radial attachment and ulnar attachments.
1.Superficial soft tissue edema predominantly along the dorsal aspect of the wrist without evidence of abscess.2.Findings suggestive of a mild inflammatory arthritis of the wrist. This is nonspecific and I cannot exclude the possibility of a septic arthritis, although the lack of significant bone marrow edema would argue against a septic joint. Small enhancing defects/erosions within multiple carpal bones are noted which I suspect are chronic in etiology.3.Other findings as above.