Boutonniere deformity

Case contributed by Dr Alborz Jahangiri

Presentation

This patient injured his left little finger at football 10 days ago. He presented with pain, swelling and deformity of the little finger.

Patient Data

Age: 56
Gender: Male
Modality: X-ray

The proximal interphalangeal joint of the fifth digit is flexed on all views, with slight hyperextension of the distal interphalangeal joint, in keeping with a boutonniere deformity and disruption of the extensor mechanism.

A tiny calcific focus dorsally is indicative of an avulsion injury. There is dorsal osteophyte formation in relation to the middle phalanx suggestive of established osteoarthritis. There is modelling deformity of the proximal phalanx head suggesting a healed fracture.

There is evidence of mild soft tissue swelling around PIP joint. 

Case Discussion

There are appearances in keeping with a boutonniere deformity of the little finger.

The osteoarthritic changes of the PIP joint is suggestive of a long standing injury.

Ultrasound could be performed to further characterize the tendons and soft tissues.

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Case Information

rID: 45787
Case created: 8th Jun 2016
Last edited: 8th Jun 2016
Inclusion in quiz mode: Included

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