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Radiological Reasoning: Acutely Painful Swollen Finger

Patrick T. Liu


Figure 1
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  		Fig. 1A —22-year-old man with painful swelling of middle finger. Sagittal T1-weighted spin-echo (TR/TE, 400/8) (A) and T2-weighted fat-suppressed fast spin-echo (4,040/70) (B) images through middle finger show elongated soft-tissue mass that contacts surface of flexor digitorum profundus tendon.

 

Figure 2
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  		Fig. 1B —22-year-old man with painful swelling of middle finger. Sagittal T1-weighted spin-echo (TR/TE, 400/8) (A) and T2-weighted fat-suppressed fast spin-echo (4,040/70) (B) images through middle finger show elongated soft-tissue mass that contacts surface of flexor digitorum profundus tendon.

 

Figure 3
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  		Fig. 1C —22-year-old man with painful swelling of middle finger. Axial T1-weighted spin-echo (460/14) (C) and T2-weighted fat-suppressed fast spin-echo (3,720/60) (D) images of middle finger (center) at level of mid shaft of middle phalanx show mass encasing flexor digitorum profundus tendon. Only minimal amount of fluid is visible in flexor tendon sheath.

 

Figure 4
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  		Fig. 1D —22-year-old man with painful swelling of middle finger. Axial T1-weighted spin-echo (460/14) (C) and T2-weighted fat-suppressed fast spin-echo (3,720/60) (D) images of middle finger (center) at level of mid shaft of middle phalanx show mass encasing flexor digitorum profundus tendon. Only minimal amount of fluid is visible in flexor tendon sheath.

 

Figure 5
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  		Fig. 1E —22-year-old man with painful swelling of middle finger. Axial T1-weighted fast spoiled gradient-echo (18/9; flip angle, 9°) fat-suppressed unenhanced (bottom) and contrast-enhanced (top) images of middle finger at level of mid shaft of middle phalanx show heterogeneous, mild enhancement of mass after IV gadolinium injection. This appearance is commonly seen in giant cell tumor of tendon sheath.

 

Figure 6
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  		Fig. 1F —22-year-old man with painful swelling of middle finger. Intraoperative photograph shows nodular mass being peeled off underlying flexor digitorum profundus tendon.

 

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