50-year-old man with atherosclerotic gangrene of the hands. Left hand:The middle finger is absent with what appears to be a soft tissue defect distal to the third metacarpal head with overlying bandage material. There is also swelling of the soft tissues of the hand with additional foci of gas density dorsal to the third, fourth and fifth metacarpals. There is loss of soft tissue along the ulnar aspect of the distal and middle phalanges of the index finger, compatible with gangrene. We see no frank osteolysis to confirm osteomyelitis. There is extensive arterial calcification in the forearm, wrist and hand as well as surgical clips the distal forearmRight hand:There is loss of soft tissue along the phalanges of the index and middle fingers which is compatible with gangrene, but we see no frank osteolysis to confirm osteomyelitis. There is a linear metallic fragment within the distal phalanx of the thumb, which may represent a foreign body, with osteolysis of the surrounding bone, which may reflect sequelae of prior infection/foreign body reaction. There is extensive arterial calcification in the forearm, wrist and hand.
Gangrene of both hands and extensive arterial calcification as described above.