Rheumatoid arthritis with changes of carpal tunnel syndrome

There is hyperintense signal detected around the flexor digitorum profundus and flexor digitorum superficialis tendon of middle and ring finger in the hand T2, PD FS images, which is extending proximally up to the level of carpal tunnel – represents its tenosynovitis. Changes are more marked around the middle finger tendons. Subtle hyperintense signal is also detected around the flexor pollicis longus tendon and flexor tendons of little finger. Small tear is noted in the flexor digitorum superficial tendon of middle finger, at the level of metacarpal bone.

There is sub articular marrow edema and cystic changes detected near ulnar margin of distal end of radius, scaphoid, lunate and capitate bones, which is hyperintense on PD FS images. Small synovial cyst is noted on ventral aspect of distal end of radius. Small intraosseous cystic area is detected in the head of the third metacarpal bone.

There is palmar bowing of flexor retinaculum detected. There is enlargement of median nerve detected at the level of pisiform bone with mild flattening in its distal portion and increased signal on PD FS images. The nerve measures around 9.6 x 4.4 mm in axial plane.

Inflammatory etiology - like Rheumatoid arthritis with changes of carpal tunnel syndrome