Reason: Is there a tumor in the flexor sheath? History: Swollen and painful finger around the PIP joint. Focal signal abnormality and thickening of the flexor tendon is observed underlying the head of the proximal second phalanx. This 1 cm long focal signal abnormality is associated with surrounding soft tissue swelling and minimal fluid, including signal changes consistent with the suspected focal synovial changes and related history of possible synovitis. Ligamentous changes are intrasubstance with discrete intact fibers observed throughout with additional punctate small foci of fluid suggesting internal minimal retraction of some intrasubstance fibers (image 22 series 14). Other than diffuse overall mild swelling of the second digit, the visualized proximal and more distal components are otherwise intact and unremarkable. Osseous structures and marrow signal are normal. No vascular abnormality. Visualized portions of the adjacent digits are also unremarkable
Focal flexor tendon abnormality underlying the head of the proximal second phalanx representing intrasubstance tear and tendinopathy. See details provided I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.