PMC9091405_01
X-ray showing mature skeleton of the right hand with large metadiaphyseal lytic intramedullary lesion in 1st metacarpal. Rest all bones appear normal.
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F1
On imaging the right hand (Fig. 1), an expansive lytic lesion was seen involving the entire metaphyseo-diahyseal region of the first metacarpal.
T1-weighted image showing a hypointense lesion in 1st metacarpal.
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F2
Magnetic resonance imaging (MRI) was performed with T1, T2, and short tau inversion recovery (STIR) imaging in multiple planes (Fig. 2, 3).
T2-weighted magnetic resonance imaging image showing hyperintense lesion in 1st metacarpal.
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F3
Magnetic resonance imaging (MRI) was performed with T1, T2, and short tau inversion recovery (STIR) imaging in multiple planes (Fig. 2, 3).
Post-operative radiograph with two k-wires fixed for intramedullary support. A volar splint was also applied for support.
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F4
A closed fixation was performed with the help of an intramedullary k-wire (Fig. 4).
Radiograph at 2 weeks follow-up showing good progress of healing.
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F5
The patient had minimal discomfort post-operative and a 2-week follow-up radiograph of the patient showed a well healing lesion (Fig. 5).
Radiograph at 4 weeks follow-up showing good progress of healing. The abnormal bone had decreased to its initial size. Good amount of callus id seen and intramedullary new bone formation is evident. Soft-tissue swelling is also decreased.
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F6
K-wires were removed at 3 weeks and a 4 weeks follow-up X-ray (Fig. 6) showed a healing fracture with good amount of callus formation, decrease in soft-tissue swelling and intramedullary calcification.