Kevin D. Plancher

History and Clinical Presentation

A 35-year-old, right hand dominant woman presented with a swollen right index finger. She reported previously having a large piece of wood that entered her finger near the metacarpophalangeal (MP) joint, but stated that she had removed the wood. A puncture wound was present over the joint and she has had progressive tenderness of the finger and increased pain with activity. Her wound has now dramatically changed after spending the weekend working in the garden.

Physical Examination

Examination reveals a warm finger with a joint effusion and surrounding soft tissue edema at the proximal interphalangeal (PF) joint of the index finger. Active and passive joint range of motion is painful. The painful joint with no evidence of cellulitis was aspirated through skin that was sterilized. The fluid obtained was turbid.

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