title: Bedside ultrasound in the diagnosis of complex hand infections: a case series.
abstract: BACKGROUND
  The red, swollen, infected hand can be a diagnostically challenging presentation in the emergency department (ED). Hand infections are a relatively uncommon ED complaint, and diagnoses may range from simple cellulitis to deep space abscess, and even to suppurative flexor tenosynovitis. The accurate differentiation of these clinical entities is of paramount importance to healing and recovery of function.
  
  
  METHODS
  In this case series, we review 4 patients with similar presenting complaints of a red, swollen hand, but with much different diagnoses and eventual treatment strategies. We describe how ultrasound was used to assist in making the diagnosis and initiating the most appropriate therapy. Finally, we review techniques for sonographic evaluation of the hand and provide imaging tips to improve visualization and accurate diagnosis. Why should an emergency physician be aware of this? Bedside ultrasound may allow for a more rapid and accurate diagnosis of various hand infections when diagnosis by physical examination is unclear.
authors.affiliation: Department of Emergency Medicine, Tufts University School of Medicine, Baystate Medical Center, Springfield, Massachusetts.
authors.forename: Brett A
authors.initials: BA
authors.lastname: Marvel
authors.affiliation: Department of Emergency Medicine, Tufts University School of Medicine, Baystate Medical Center, Springfield, Massachusetts.
authors.forename: Gavin R
authors.initials: GR
authors.lastname: Budhram
mesh_terms: D000328:Adult; D001170:Arthritis, Infectious / Q000000981:diagnostic imaging; D001424:Bacterial Infections / Q000000981:diagnostic imaging* / Q000628:therapy; D004636:Emergency Service, Hospital; D005260:Female; D006225:Hand / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D013717:Tenosynovitis / Q000000981:diagnostic imaging; D014463:Ultrasonography
keywords: cellulitis; hand infection; imaging; tenosynovitis; ultrasound