Osteomyelitis First digit (thumb): There is no evidence of osteomyelitis. There are osteoarthritic changes of the MCP joint.Second digit (index): There is abnormal signal intensity and enhancement of the distal and middle phalanges of the index finger as well as destruction of the base of the distal phalanx and the majority of the middle phalanx. There is inflammation and edema of the surrounding soft tissues with an enhancing tract extending to the dorsal surface of the digit. There is no definite fluid collection to suggest abscess within the distal index finger. There is enhancement along the flexor tendon apparatus that extends proximally to the level of the mid metacarpal. The flexor digitorum superficialis splits at the level of the of the distal diaphysis of the second metacarpal with both halves extending deep to the profundus tendon; this may represent a normal Camper's chiasm accentuated by tenosynovitis although the presence of a longitudinal split tearing of the tendon cannot be excluded. Arthritic changes at the second MCP joint are likely degenerative in etiology. There is mild enhancement and edema of the base of the proximal phalanx of the index finger which is thought to be secondary to the arthritic changes or reactive to the flexor tenosynovitis as opposed to osteomyelitis. Edema extends from the index finger into the thenar eminence with additional mild soft tissue inflammation of the remaining hand.Third digit (middle): There is amputation of the ring finger through the base of the middle phalanx. There is no evidence of osteomyelitis.Fourth digit (ring): There is chronic erosive deformity of the PIP joint but no marrow signal abnormalities to indicate osteomyelitis.Fifth digit (pinky): There is no evidence of osteomyelitis.Wrist: Multiple low signal intensity foci are noted within the carpal bones which likely reflect degenerative cysts or chronic erosions. There is no evidence of osteomyelitis. There is perhaps a small chronic erosion of the radial styloid, but marrow signal intensity of the visualized portions of the distal radius and ulna is normal. There is mild synovitis of the distal radioulnar joint and perhaps mild tenosynovitis along the extensor tendons of the first dorsal compartment.
Osteomyelitis of the distal and middle phalanges of the index finger with tenosynovitis of the flexor apparatus and other findings as described above.