A 62-year-old male with a past medical history of chronic liver disease, rheumatoid arthritis and rheumatoid arthritis presented with pain and swelling in his right hand 10 days after onset of chronic pinchar emphysema.
He was initially treated in his primary care center with oral ciprofloxacin without improvement.
Physical examination revealed pain with passive extension of the fingers and a subcutaneous palm abscess.
1.
The hand ultrasound shows a hypoechogenic area surrounding the flexor tendons throughout the cubital bursa that continues to the medial palm space and the skin.
Color Doppler imaging confirms synovial hypervascularization.
Open drainage and evacuation of large amounts of pus after opening the ulnar ring ligament and bursa were performed.
