Reason: R Small Finger Chronic Dislocation History: Boutonierre Deformity The extensor digiti minimi tendon can be followed to the level of the PIP joint of the fifth digit of the right hand at which point it becomes indistinct and is likely completely disrupted. There is a flexion deformity about the PIP joint. There is a moderate amount of fluid within the PIP joint of the fifth digit which may represent a synovitis. The DIP joint is held in extension. There is circumferential fluid within the common flexor tendon which may reflect a mild tenosynovitis. There is bowstringing of the common flexor tendon at the level of the PIP joint suggesting disruption of the A3 pulley. There is slight increased bone marrow signal abnormality within the base of the middle phalanx of the fifth digit which may represent a contusion. There is soft tissue inflammatory changes/swelling in the surrounding area.
1. Disruption of the extensor digiti minimi tendon at the level of the PIP joint as described above. There is an associated boutonniere deformity of the fifth digit. The small avulsion fracture fragment seen on prior radiographs is not well visualized on this examination.2. Bowstringing of the common flexor tendon may reflect disruption of the A3 probably of the fifth digit as described above.