Human bite There is diffuse soft tissue edema and enhancement of the index finger particularly surrounding the middle phalanx suggestive of cellulitis. There is a small skin defect along the radial aspect of the middle phalanx with an underlying approximately 1 cm focus of nonenhancing tissue which could represent phlegmonous change or early abscess formation that we suspect is continuous with the aforementioned skin defect. Although the enhancement and edema contacts the flexor tendon apparatus, we see no frank fluid within or enhancement of the tendon sheath itself and there is no extension of this process proximal to the MCP joint.A small amount of fluid and enhancement is seen within the PIP joint and while this could represent a reactive synovitis, we cannot exclude the possibility of early infection. There is no bone marrow edema to confirm septic arthritis or osteoarthritis. The remaining digits of the hand are unremarkable.
1. Skin defect and cellulitis of the index finger with underlying nonenhancing collection which may reflect phlegmon/early abscess that is suspected to communicate with the overlying skin defect.2. Enhancement of the PIP joint of the index finger indicating synovitis and although this could be reactive in nature, the possibility of early infection cannot be excluded.3. No evidence of osteomyelitis. 