Wrist lump ?severe tenosynovitis ?giant cell tumour

[Sara Quixley]

Hi Steve,
70y.o lady came in for her left wrist ultrasound. Palpable lump over her left wrist dorsum for last 12months. Non tender, but it has restricted her wrist movement recently.
It has significantly increased in size for the last few months, first started as a pea sized lump.
Extensive amount of hypoechoic “solid” appearing tissue surrounding extensor digitorum tendons from distal MTJ to 4th extensor compartment. What do you reckon?
The cine loop file is
?severe tenosynovitis ?could it be giant cell tumour around the extensor digitorum tendons

Thanks
Sara

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[Stephen Bird]

Hi Sara,

Nice case,

This is a fairly typical appearance for rheumatoid disease affecting Extensor compartment 4.

I think a GCT is less likely,

It looks like gross synovial proliferation as you get in rheumatoid.

I would say this is my primary diagnosis.

Steve.

[Sara Quixley]

Thanks Steve! Many thanks for your time 🙂

[Stephen Bird]

Always a pleasure Sara,

Keep the questions coming,

Steve

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