Osteoarthritis and septic arthritis - index finger

Case contributed by Bahman Rasuli
Diagnosis almost certain

Presentation

Swan neck deformity of index finger from 3 years ago. Pain and swelling of index finger from 5 days ago.

Patient Data

Age: 60 years
Gender: Female

Abnormal bone marrow signal around the distal interphalangeal joint of the index finger, appearing low on T1 images and high on proton density images.

Effusion of the distal interphalangeal joint associated with capsular hypertrophy.

Marginal osteophyte formation at the base of index finger distal phalanx.

Degenerative subchondral cystic changes along with the index finger, the base of the distal phalanx, and middle phalanx head.

Case Discussion

Imaging findings are suggestive of septic arthritis superimposed on osteoarthritis in the distal interphalangeal joint of the index finger causing the boutonniere deformity.

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