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Bowler's thumb

Case contributed by Leanne Yuanci Lin
Diagnosis certain

Presentation

Collegiate bowler presents with pain, swelling, and tingling of the right thumb with associated numbness and tingling of the first two digits. She reports no acute injuries, however, the pain is worse with bowling. She hasn't been able to bowl for the past week and a half.

Patient Data

Age: 19
Gender: Female
x-ray

Plain radiograph of the right thumb and hand is unrevealing.

MRI of the right thumb

mri

Thickening of the digital branch of the median nerve along the volar aspect of the thumb at the level of the proximal phalanx.

Annotated image

Thickening of the digital branch of the median nerve (red circle) along the volar aspect of the thumb at the level of the proximal phalanx.

Case Discussion

Plain radiography of the right thumb and hand are unrevealing of acute osseous pathology. MRI was obtained through the right thumb demonstrating thickening of the digital branch of the median nerve in keeping with bowler's thumb. 

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