Flexion contracture status post trigger release. Evaluate A2 pulley of right index and long fingers. The A2 pulley of the index finger appears intact. The flexor tendon apparatus of the index finger appears normal. The extensor tendon is difficult to visualize dorsal to the middle phalanx; however, its insertion on the middle and distal phalanges appear intact. Mild osteoarthritis affects the second metacarpophalangeal joint. Bone marrow signal intensity is normal.The A2 pulley of the middle finger appears intact. There is mild edema-type signal along the volar margin of the flexor tendon apparatus at the level of the third metacarpal head, which may reflect surgical changes of trigger finger release. The flexor digitorum superior superficialis and profundus tendons appear slightly thickened as they course of volar to the proximal phalanx suggesting tendinosis and perhaps mild interstitial tearing, but I see no frank tendon rupture. A small amount of fluid in the tendon sheath at this same location suggests a mild tenosynovitis. There is also a small amount of fluid in the soft tissues along the volar aspect of the A2 pulley, but again, the underlying pulley itself appears intact. The extensor tendon is difficult to visualize dorsal to the middle phalanx; however, its insertion on the bases of the distal and middle phalanges appear intact. Moderate osteoarthritis affects the third metacarpophalangeal joint with small cysts in the third metacarpal head and base of the third proximal phalanx. Bone marrow signal intensity is otherwise unremarkable.
1.Normal-appearing A2 pulleys of the index and middle fingers.2.Mild tendinosis and tenosynovitis of the flexor tendon apparatus of the middle finger.3.Osteoarthritis of the second and third MCP joints - a pattern that can be seen in patients with CPPD arthropathy.