Wk 2, Case 5 - Review

Patient History
41-year-old female complaining of a mass located at the distal interphalangeal joint of the 2nd finger that has been present for the past 8 months which has been increasing in size and is tender.

Findings

LIGAMENTS: Intact.

OSSEOUS: Focal chondromalacia with subchondral arthropathic cysts at the 2nd metacarpophalangeal joint.

TENDONS: Intact.

GENERAL: A 1.2cm x 0.7cm x 0.7 cm (craniocaudal, AP and transverse dimensions) well-circumscribed subcutaneous solid mass demonstrating intermediate to low T1 signal, slightly increased STIR signal and subtle peripheral enhancement is located at the palmar ulnar aspect of the right 2nd digit DIP joint abutting the flexor digitorum longus tendon.

Impressions
1. A 1.2cm x 0.7cm x 0.7cm well-circumscribed mass demonstrated low to intermediate T1, subtle increased T2 signal and peripheral enhancement located at the palmar ulnar aspect of the 2nd digit DIP joint. The mass abuts the flexor digitorum longus tendon without associated osseous erosions. Favor an epidermoid. Less likely considerations include an atypical ganglion cyst, schwannoma, thrombosed varix or less likely nodular synovitis, in descending order of preference.