Evaluation of Hand Infections

Abstract

<p>Physical examination is important in accurately diagnosing hand infections. Inspection by <em>looking</em> yields clues to the anatomical location of pathology (e.g. pustular collection around the nail bed in acute paronychia, erythematous and swollen finger pulp in felon), palpation through <em>feeling</em> elicits tenderness over involved compartments (e.g. along the volar aspect of the whole finger in flexor tenosynovitis, palmar regions in corresponding deep space infections), while active or passive ranges in <em>moving</em> provide hints on inflamed structures (e.g. pain on passive digital extension in flexor tenosynovitis, reduced range of motion in septic arthritis). In this chapter, physical examination and signs for the evaluation of common hand infections are covered, including acute paronychia, felon, flexor tenosynovitis, webspace infection, deep palmar space infection, Parona’s space infection, and septic arthritis of the wrist, aided by explanation of clinically relevant anatomy. Upon completion of this chapter, the reader is expected to be competent in the assessment, differentiation, and diagnosis of hand infections, to facilitate subsequent prompt and appropriate orthopaedic management.</p>