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
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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