31-year-old female. Right dorsal hand cellulitis failed PO antibiotics, evaluate for abscess. Again seen is edema within the dorsal soft tissues of the wrist and hand which enhances and extends into the fingers, compatible with cellulitis. There is also a nonenhancing collection of fluid signal intensity within the soft tissues dorsal to the third, fourth, and fifth metacarpals with perhaps a thin rim of enhancement. The collection surrounds the third and fourth extensor tendons although there does not appear to be fluid within the tendon sheaths themselves. Part of the collection lies deep to the third and fourth extensor tendons suggesting involvement of the subaponeurotic space. The fluid extends into the bases of the third, fourth, and fifth fingers dorsal to the extensor tendons. The overall size of this collection is approximately 1 cm in AP dimension, 5 cm in radioulnar dimension, and approximately 5 cm in longitudinal dimension. Edema and enhancing tissue extends into the palmar soft tissues along the head and neck of the fourth metacarpal. There may be mild synovitis of the fourth MCP joint. We see no fluid in the flexor tendon apparatus. We see no fluid collections or significant edema within the musculature of the hand. A small focus of signal abnormality in the third metacarpal head may represent a cyst, unchanged from prior study.
Cellulitis with findings suggestive of a dorsal soft tissue abscess, as described above.