Hand infections: anatomy, types and spread of infection, imaging findings, and treatment options.
Infections of the hand are common, particularly in immunocompromised patients, and can lead to significant morbidity, including amputation, if not treated properly. Hand infection can spread far and wide from the original site of inoculation through interconnections between the synovium-lined and nonsynovial potential spaces. Because surgery is the mainstay of treatment, knowledge of the pertinent anatomy is imperative for accurately describing the presence, location, and extent of infection. The authors review the pertinent anatomy of the spaces of the hand and describe different types of infection-including cellulitis, necrotizing fasciitis, paronychia, felon, pyogenic flexor tenosynovitis, deep space infections, septic arthritis, and osteomyelitis-and common causative organisms of these infections. They also describe various modes of spread; the common radiologic appearances of hand infections, with emphasis on findings at magnetic resonance imaging and ultrasonography; and the role of radiology in the management of these infections, along with a brief overview of treatment options.
From the Departments of Radiology (D.B.P., N.B.E., G.R.M., C.J.G., D.M.F., E.A.W.) and Orthopedic Surgery (M.V.S.), Keck School of Medicine, University of Southern California, 1500 San Pablo St, 2nd Floor Imaging, Los Angeles, CA 90033-5313.
Dakshesh B
DB
Patel
Neelmini B
NB
Emmanuel
Milan V
MV
Stevanovic
George R
GR
Matcuk
Christopher J
CJ
Gottsegen
Deborah M
DM
Forrester
Eric A
EA
White
D003937:Diagnosis, Differential; D006225:Hand / Q000033:anatomy & histology; D006801:Humans; D007239:Infections / Q000175:diagnosis* / Q000382:microbiology; D012307:Risk Factors