Foreign body induced septic arthritis of the finger

Case contributed by Maulik S Patel
Diagnosis certain


Thorn injury to the dorsal aspect of the second proximal interphalangeal joint 19 days ago. Now complaining of index finger swelling and loss of movement.

Patient Data

Age: 30 years
Gender: Male

Proximal interphalangeal joint shows

  • effusion in dorsal and palmar recesses
  • synovial thickening and hyperemia
  • erosion on dorsal aspect of proximal phalanx (also seen on plain radiograph - not provided)
  • linear echogenic focus (1.2 mm long) is seen deep to extensor tendon consistent a foreign body, deep to ulnar side of lateral slip of extensor tendon

Flexor tendon is intact with no evidence of tenosynovitis. Extensor tendon is intact.

Soft tissue edema on dorsal and palmar aspects of proximal interphalangeal joint with hyperemia.

Intra-operative photos show a tiny dark-colored foreign body and erosion of the phalanx.

Case Discussion

Ultrasound findings of foreign body-induced septic arthritis of index finger proximal interphalangeal joint.

Surgical exploration revealed a thorn fragment and erosion of the phalanx.

Intra-operative photos are courtesy operating surgeon, Dr Pinkesh Patel.

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