Reason: abnormality History: swelling and painful movement The fourth and fifth proximal interphalangeal joints are held in flexion. There is apparent fluid within the flexor digitorum profundus tendon sheath of the fourth and fifth digits indicating a tenosynovitis (best seen on sagittal STIR sequence, image 5 series 12). The flexor and extensor tendons appear intact. There is suboptimal evaluation of the pulleys of the fourth and fifth digits due to the inability to optimally position the patient due to the aforementioned flexion deformities. There is increased signal abnormality within the head of the fifth metacarpal which appears to be linear on coronal T1 weighted sequences which is nonspecific but may be posttraumatic in etiology in the correct clinical setting. There is a small amount of fluid within the first through fifth MCP joints which is not necessarily of any clinical significance. No additional bone marrow signal abnormality is identified. The imaged musculature of the hand is otherwise unremarkable.
1. Flexion deformity of the fourth and fifth fingers as described above. Findings indicating a tenosynovitis of the flexor digitorum profundus tendons of the fourth and fifth digits.2. Nonspecific bone marrow reactive change within the fifth metacarpal head may be posttraumatic in etiology. Dedicated hand radiographs are recommended for further evaluation. Infectious and inflammatory etiologies could be considered in the correct clinical context.