69-year-old female status post burn to the left index finger, please evaluate for osteomyelitis. There is acroosteolysis of the distal phalanx of the index finger of the left hand. There is diffusely abnormal marrow signal within the distal phalanx with abnormal contrast enhancement of the bone marrow. Further, there is a soft tissue defect at the tip of the index finger with a T2 hyperintense sinus tract that appears to communicate between the cutaneous surface and the underlying distal phalanx.The middle phalanx demonstrates mild edema, likely representing reactive osteitis without evidence of osteomyelitis. There is no significant joint effusion. Otherwise, the extensor and flexor tendon complexes of the index finger appear intact. Findings compatible rheumatoid arthritis about the carpus in multiple MCPs with superimposed osteoarthritis.
Soft tissue swelling and osteolysis indicative of osteomyelitis secondary to history of burn injury of the distal phalanx of the index finger. Further, a sinus tract extends from the cutaneous surface to the underlying bone. Reactive osteitis is visualized within the middle phalanx, without definite findings of osteomyelitis.