We report a rare case of fat-fluid levels in the extensor tendon sheaths of the wrist on MRI. An 18-year-old female sustained a direct injury to her left hand while playing soccer. Plain radiographs showed soft tissue swelling with no definite fracture plane appreciated on the initial review of the images. The pain and swelling were severe and an MRI was obtained to evaluate for fracture and soft tissue injury. The MRI demonstrated a cortical defect near Lister’s tubercle and multiple fat-fluid levels within the extensor tendon sheaths. This is the first reported case of fat-fluid levels within the extensor tendon sheaths on MRI, with only one previous case report of this entity on CT.