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Finger PIP joint septic arthritis and osteomyelitis

Case contributed by Craig Hacking
Diagnosis certain

Presentation

Swollen middle finger PIP joint. IVDU, alcoholic. Exclude osteomyelitis.

Patient Data

Age: 40 years
Gender: Female

Marked soft tissue swelling of the middle finger. The PIP joint space is narrowed and less distinct than adjacent interphalangeal joints. Focal osteopenia of the head of the proximal phalanx and a smooth periosteal reaction of both the middle and proximal phalanges is adjacent to the joint. Features are in keeping with osteomyelitis and septic arthritis.

Case Discussion

The patient was taken to theater and the joint washed out. Pus was found in the joint and S.aureus was cultured.

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