There is a thin-walled predominantly anechoic cyst (5 x 4 x 3 mm) abutting the A1 pulley at the 3rd metacarpophalangeal joint. There is no vascularity in the lesion. The A1 pulley is intact. There is no tendon thickening/tenosynovitis/flexor tendon tear. Palmar plate is intact. There is no metacarpophalangeal joint effusion. The lesion is free from adjacent neurovascular bundles. Dynamic interrogation shows free tendon movements.