CRP: 0.7 mg/dL; ESR: 1.2 mg/dL
X-ray:
Two hypodense lesions around 0.6 cm in diameter in the middle phalangeal base of right index finger with adjacent soft tissue swelling, infectious process is likely. DDx include metastatic lesion
MRI:
MR scans of the right hand under SE T1WI and FSE T2WI on axial, coronal,and sagittal planes without and with intravenous administration of gadolinium was performed and revealed
Marked increased thickness of synovium at proximal interphalangeal joint (much prominence on dorsal site) with good enhancement, central low signal, and erosion of middle phalangeal base of the right index finger
Impression:Infectious process of right index finger PIP joint with suspicious bascess foramtion, suggest surgical intervention
Pathology
Synovium, finger, index, right, excision, chronic inflammation.Bone, finger, index, right, excision, necrosis.
Description:The specimen is submitted in 2 bottles labeled as A:synovium, and B: bone, fixed in formalin.Bottle A, consists of more than ten tissue fragments measuring up to 0.1x0.1x0.1 cm in size.
Grossly, they are whitish and elastic.Bottle B, consists of more than ten tissue fragments measuring up to 0.2x0.1x0.1cm in size. Grossly, they are whitish and elastic.All for section and labeled as follows: Jar:0 HsuAB: bottle A; C: bottle B;
Microscopically, the synovial tissue show chronic inflammation with lymphoplasmacytic infiltration. The bone tissue is necrosis.
Dr.R.H.Huang
