Wk 4, Case 2 - Review

Patient History
31-year-old male with left finger pain. Evaluate for flexor tendon injury.

Findings
LIGAMENTS: Complete rupture of the ulnar and radial sides of the 4th finger A2 through A4 pulleys.

TRIANGULAR FIBROCARTILAGE COMPLEX: Not evaluated.

OSSEOUS: No fracture or dislocations. No osteoedema.

TENDONS: Sagittal T1 and STIR images demonstrate an intact flexor digitorum superficialis (FDS) with intermediate to high signal intensity, respectively, replacing the 4th flexor digitorum profundus (FDP) tendon within the distal fibroosseous tunnel at the level of the 4th A2-A4 pulleys and at the level of the 4th middle phalanx. Coronal sequences demonstrate laxity of the 4th FDP, which is coiled within the palm adjacent to a normal-appearing FDS. The coil tendon is located at the level of the 4th metacarpal head.

CARPAL TUNNEL AND GUYON’S CANAL: Not evaluated.

GENERAL: Palmar soft tissue swelling involving the entire 4th finger.

Impressions
1.Complete rupture/avulsion of the right 4th finger FDP, which is retracted into the palm and coiled at the level of the metacarpal head.
2.Complete rupture of the 4th finger A2-A4 pulleys.
3.Diffuse soft tissue swelling throughout the palmar aspect of the 4th finger.
4.Intact FDS.