Osteomyelitis There is diffuse soft tissue edema and inflammation of the radial portion of the hand and entirety of the thumb. There is T1/high T2 signal of the distal phalanx of the thumb consistent with osteomyelitis. Additional areas of increased T2 signal are noted within the proximal phalanx without corresponding T1 signal and this is likely reactive in nature. Although no discrete fluid collection is identified, there is ill-defined peripheral enhancement on the volar portion of the distal phalanx likely representing phlegmonous change. The distal attachment of the flexor tendon is not well seen which may be the result of partial tearing/rupture. The remaining fingers demonstrate normal marrow signal. A small amount of fluid is noted within the first MCP joint.Diffuse edema affects the thenar musculature. The median nerve is also enlarged.
Osteomyelitis of the distal phalanx of the thumb. Although there is no discrete fluid collection, surrounding phlegmonous change tracks into the thenar eminence.