No bone marrow edema is seen. There is extensive deep soft tissue edema about the palmar aspect of the small finger centered about the flexor tendon. Findings of tenosynovitis of the flexor tendon.
There is palmar dislocation of the flexor tendon, the distance between the middle phalanx and flexor tendon is 7mm. There is disruption of the A2 pulley best seen on axial series 3 image 24 and sagittal series 4 image 5.
The flexor tendon itself is intact. No significant joint effusion. No bone marrow edema. No dislocations seen.
So what does that mean? If you look at the way your finger operates, the tendons that allow you to flex (close/contract/etc.) your finger start somewhere around the middle of your forearm and run all the way to the tips of your fingers. If they were just hanging around loose, every time you contracted your finger, that tendon would form a taught line between the tip of your finger and the palm of your hand – kind of like how your hamstring does when you flex it. Obviously, this would cause problems for the whole "manual dexterity" thing that supposedly separates us from animals, so those flexor tendons run through sheaths attached to each of the three bones in your hand that keep the tendon flush up against those bones; these sheaths are, oddly enough, called pulleys.
It turns out that I somehow managed to rupture the primary pulley on the first bone of my right pinkie finger sometime between six and nine months ago – take a look at your pinky; 7mm is a lot of distance for that particular appendage. I thought the pain/swelling/lack of range of motion/etc. was due to a cut a soup can lid inflicted on the first interphalangeal joint, but the MRI indicated that it was completely and totally unrelated.
Incidentally this just goes to show that doctors are not omniscient. Mine did not really see the point of doing an MRI, since nothing showed up on x-rays indicating that anything was wrong, but being an engineer, I wanted to know why I was in this kind of pain, so I insisted… and, lo and behold, we found an answer, and one that was completely unexpected. As always, you and you alone are responsible for your well-being.
So what does all that mean? My right pinkie finger is functionally useless. The whole first segment of the finger is swollen to about twice its normal circumference, any attempts to put pressure on the finger in any direction on any axis results in increasing amounts of pain, its range of motion has been cut to 50-60% of normal, and it can no longer grip with anything approximating force (My left hand can grip with 110PSI; my right is down to 85, and I am right-handed.). Resting pain, with the finger doing nothing at all, runs about a 1 or 2 depending on the day, with the maximum hitting about an 8 today when the doc was verifying the MRI reading by poking and prodding and telling me to push against his finger. Radiating pain (or whatever the term is) and swelling runs all the way down my palm into my wrist, making push-ups possible on good days, but not pleasant.
Treatment consists of physical therapy to try and beat the swelling down (which sounds awesome) followed by using tape, compression hose, or even just a ring to basically take the place of the missing pulley. Extreme cases can be addressed by surgery, which basically involves flaying open the entire finger, taking a tendon (the doctor did not specify from where, I noticed), and creating a new pulley, but even that will take 2-3 months of PT to recover from (and involves the aforementioned finger-flaying). While your body is capable of marvelous things like knitting bone and so forth, regrowing/repairing tendons/pulleys is apparently something evolution never invested skill points in. Never figured on wearing a pinky ring, but I guess I have a while to find an awesome one (any metalsmiths amongst my readers?) – the ring I wear on my right ring finger cannot even fit on my pinky at the moment.
Apparently this is a fairly common injury for rock climbers and the like, given that they are frequently trying to suspend their entire body’s weight by their fingernails, but I honestly have no idea how I managed to accomplish it; it might have been karate, but it might have been something as silly as trying to carry too many heavy grocery bags in one hand. I certainly do not remember any distinct popping sensations.
So what does this really mean, to you? Not much; I was just sharing the results of my first ever MRI. Posting frequency will probably decrease a touch – typing is distinctly painful – and I will be even more cranky than normal, especially since any range time will cause more pain than it will alleviate stress, but we have full health insurance and everything is covered. You have no idea how silly I feel over having to go to physical therapy for a pinky finger, though… If you are feeling generous, however, I can think of someone who could use your help a lot more, and you might even get something more than warm-and-fuzzies out of it to boot.
(Also, MRIs? I do not see the big deal. But, then, I have never been claustrophobic… ever, so far as I can recall. Put that MRI machine on the edge of the Grand Canyon and we might have problems, though…)