Reason: r/o osteomyelitis History: Right wrist cellulitis There is a 1.8 x 1.4 cm focus of increased signal abnormality within the subcutaneous tissue along the dorsal and radial aspect of the wrist which likely represents an early evolving abscess/phlegmon formation, although this is incompletely characterized on this nonenhanced examination. No drainable fluid collection is identified. There is an additional focus of decreased T1 and intermediate T2 signal abnormality along the dorsal and radial aspect of the scaphoid which also may represent phlegmon or early evolving abscess, although this is also incompletely characterized on this noncontrast examination. Again no drainable fluid collection is identified. There is skin thickening along the dorsal aspect of the wrist. There is nonspecific subcutaneous edema and inflammatory change in the surrounding area which extends volarly to involve the lumbrical musculature between the first and second as well as between the second and third metacarpals. No bone marrow signal abnormality is identified to suggest osteomyelitis. There is no frank cortical destruction. There is a linear band of low signal abnormality traversing the scaphoid which may reflect prior remote trauma. There is a trace amount of fluid within the distal radioulnar joint of doubtful current clinical significance. There is subchondral cyst formation within the first metacarpal head. Skin markers overlie the radial aspect of the wrist.
Foci of signal abnormality along the dorsal and radial aspect of the wrist may represent phlegmon/early abscess formation, however, no drainable collection is identified, within the limitations of this noncontrast examination. Subcutaneous and soft tissue inflammatory change, most pronounced along the dorsal aspect of the wrist, as described above without evidence of osteomyelitis.