Reason: previous infection and GSW to the hand-sensitivity of hand-palm and unable to move index finger. History: pain and swelling and stiffness There is near complete to complete interval resolution of the previously described fluid collection along the volar aspect of the palm. The previously seen bullet fragment is also not well-visualized on today's examination and may have been removed. There is linear decreased signal abnormality in the surrounding area which likely represents scarring or postsurgical change. The palmaris longus tendon is indistinct in the adjacent area and may be disrupted.Again seen is bone marrow signal abnormality within the second metacarpal head, neck, and diaphysis consistent with the patient's known history of a nondisplaced fracture. Again seen is heterogeneity and increased signal abnormality within the volar plate of the second MCP joint indicating disruption. The A1 pulley of the index finger is again noted to be indistinct likely indicating disruption. The flexor digitorum superficialis tendon appears intact. However, the flexor digitorum profundus tendon of the index finger is again noted to deviate laterally and appears to terminate at the level of the MCP joint indicating a tear. The remaining visualized tendons of the hand appear intact.
1. Interval resolution of the previously described fluid collection within the volar soft tissues of the mid palm.2. Nondisplaced fracture of the second metacarpal.3. Disruption of the volar plate of the MCP joint and A1 pulley of the index finger, appearing similar to the prior study.4. Findings suggestive of disruption of the flexor digitorum profundus at the level of the MCP joint of the index finger, appearing similar to the prior study.