55-year-old male with two weeks of fever, right upper extremity swelling, pain Replacing/insinuating between the fibers of the abductor pollicis brevis muscle is a collection of high T2 signal with peripheral rim enhancement measuring 4.5 x 1.3 cm (series 26, image 22). Adjacent to this collection is a second rim-enhancing fluid collection surrounding the flexor pollicis longus tendon and displacing the adductor pollicis brevis muscle dorsally, measuring 2.1 x 1.4 cm (series 26, image 21). Mild enhancement and edema type signal is noted within the adductor pollicis brevis muscle belly.A third rim-enhancing, lobulated fluid collection is noted in the first interdigital web space, along the medial and volar aspect of the adductor pollicis brevis muscle measuring 2.3 x 1.7 cm (series 26, image 16).Enlargement and signal abnormality of the flexor pollicis longus and fourth and fifth flexor digitorum superficialis tendons. Fluid tracks along the flexor compartment extending towards the carpal tunnel demonstrating peripheral enhancement. No significant abnormal bone marrow signal. Mild degenerative disease affects the carpometacarpal and partially visualized intercarpal joints.
Multiple rim-enhancing fluid collections insinuating between the abductor pollicis brevis muscle fibers, surrounding the flexor pollicis longus tendon, and in the first interdigital web space as described above are suspicious for abscess. No convincing evidence of osteomyelitis. Other findings as above.Findings discussed with Dr. Kyle Borque at 1130 on 11/22/15. 