The patient is a 24-year-old right-handed amateur female tennis player who presented with a 4-week history of progressively worsening left ulnar-sided wrist pain (USWP). Onset of pain was gradual, with no inciting traumatic event. Specifically, her pain was most severe when hitting her two-handed backhand. Symptoms associated with instability such as wrist ‘clunking’ and neurological symptoms such as paresis or paresthesia were absent. Physical examination revealed point tenderness over the distal ulna.

To assess the patient’s wrist pain, plain X-rays and ultrasound were obtained for initial investigation. An MRI was subsequently requested to rule out coexistent pathology.

Plain film radiography is typically the initial imaging modality used for the investigation of USWP. It is safe, fast and inexpensive and useful for excluding fractures, dislocations, arthritis or positive ulnar variance (associated with …