Clinician-performed ultrasound in identifying osteomyelitis of the hand.

Osteomyelitis of the metacarpal and phalangeal bones of the hand is relatively uncommon, but can have severe consequences such as functional impairment or amputation. Precipitating events can include an open fracture or a puncture injury, local infection or surgery, or, less commonly, hematogenous spread (1). The presenting signs of osteomyelitis, regardless of location, include local and systemic symptoms such as pain, swelling, erythema, fever, and chills. These findings are nonspecific and often not helpful in differentiating osteomyelitis from other infections. In most cases of osteomyelitis of the hand, the correct diagnosis is made more than 1–6 months after symptoms begin (1). The successful management of osteomyelitis requires early diagnosis along with a combined surgical and medical approach.