55-year-old male with right index finger pain, concern for collateral ligament disruption. There is increased signal intensity within the proximal fibers of both the medial and lateral collateral ligaments of the proximal interphalangeal joint on the short TE images compatible with injury. However, we see no frank disruption of the ligaments on the T2-weighted images. These findings are most compatible with sprain. There is a small proximal interphalangeal joint effusion. Mild osteoarthritis affects the distal interphalangeal joint. The metacarpophalangeal joint is unremarkable. There is a small amount of fluid within the tendon sheath of the flexor apparatus as it passes under the metacarpal head and volar to the proximal interphalangeal joint, but the tendons otherwise appear normal. We see no findings to suggest pulley disruption. There is a small cyst in the head of the metacarpal, but otherwise the bone marrow signal is within normal limits.Small subchondral cysts are also noted within the interphalangeal and metacarpophalangeal joints of the thumb as well as at the proximal interphalangeal joint of the middle finger.
Sprain of the collateral ligaments of the proximal interphalangeal joint of the index finger without frank disruption, and other findings as above.