Septic arthritis - proximal interphalangeal joint

Case contributed by Bahman Rasuli
Diagnosis almost certain


Middle finger swelling and pain following prune of garden trees 3 weeks ago.

Patient Data

Age: 75 years
Gender: Male

Abnormal bone marrow signal around the proximal interphalangeal joint of the middle finger, appearing low on T1 images and high on proton density images, as well as cortical erosion (best appreciated on T1 images) of the distal of proximal and base of middle phalanges of the middle finger.

Joint effusion of the proximal interphalangeal joint.

Marked subcutaneous edematous changes and swelling is noted along the middle finger.

Case Discussion

Imaging findings are suggestive of septic arthritis and osteomyelitis the proximal interphalangeal joint of the middle finger. Progressive swelling and pain with limited finger mobility are important clinical findings.

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