Hello Dr. Siegel - I am looking for some guidance. I have seen two orthopedic surgeons in New York City, I ve had x-rays and and MRI (wrist and middle finger right hand). My issue is that the middle knuckle on my middle finger of the right hand is swollen seems enlarged and a bit twisted. The problem started in the first quarter of 2012 with my wrist - initially thought it was a ganglion cyst however this was not the case. The first doctor said possible tendosynovitis. Subsequently my middle knuckle on my middle finger of the right hand became stiff and swollen. It looks enlarged a bit discolored and twisted. I went for a second opinion and had an MRI performed. The diagnosis was tendosynovitis. I was offered cortisone which I declined (had a reaction to corticosteroids when injected into foot to treat a neuroma). I went to physical therapy which helped the wrist. I also changed my computer keyboard and used a wrist brace for a few months. The wrist is much better now but, the knuckle is still the same. I was told I don t have arthritis, any fractures or joint damage. Surgery was not recommended either. Do you have any idea what could cause this? I will be seeing a hematologist for another reason and will also ask the doctor what he thinks. Could it be a bacterial or viral cause? I am a healthy woman in my 30 s I exercise and eat very well (lots of fresh food and never any processed food). I am totally stumped and any guidance or recommendations would be much appreciated. Thank you.