Presentation
Cat bite approximately 2 weeks prior, presenting with ongoing pain, swelling and limitation of motion of the right second digit.
Patient Data
There is an asymmetric and significant, right second digit, PIP joint space narrowing with soft tissue swelling of the digit especially centered around the affected joint. There is subtle juxta-articular osteoporosis. There is no bone erosion or destruction of the affected PIP joint.
Case Discussion
There is aggressive cartilage destruction and consequent joint space narrowing of the right second PIP joint without any bone changes. Bone destruction will often develop and lead to ankylosis and premature degenerative change especially if diagnosis and appropriate treatment is delayed.
There is well-identified regional soft tissue swelling suggestive of associated cellulitis.
Features consistent with acute septic arthritis of the right second PIP joint. A complimentary ultrasound confirmed septic arthritis and a small focal soft tissue abscess, complex small joint effusion, and a tiny sinus tract corresponding to the site of penetration when bitten by his cat.
Case courtesy of Dr Amaresh I Ranchod.