RADIOLOGY MCQ --AIPGMEE AND FRCR--The lotus root sign

The lotus root sign 

De Quervain disease is stenosing tenosynovitis of the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons in the first extensor compartment of the wrist


Hiranuma classification. 
(a) Normal type of de Quervain disease (Hiranuma type I). APL and EPB run in the same sheath. 
(b) Complete septation (Hiranuma type II). APL and EPB run in separate tendon sheaths.
 (c) Incomplete septation (Hiranuma type III). APL and EPB run in separate tendon sheaths in only the distal portion.
 (d) EPB-lacking type (Hiranuma type IV). Tendon sheath is normal but lacks EPB.



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 (a) Photograph of the sliced lotus root. (b) Photographic negative of a transverse US image shows the lotus root sign. This sign suggests three or more tendon slips in one compartment. Negatively inverted tendon slips look like holes of the sliced lotus root.



a.


b.



SOURCE ---http://pubs.rsna.org/doi/suppl/10.1148/radiol.11102458