Osteomyelitis and septic arthritis complicating hand injuries and infections: pathogenesis of roentgenographic abnormalities.

Osteomyelitis and pyarthrosis may complicate hand injuries and soft-tissue infections, resulting in characteristic radiographic findings. Evaluation of 78 patients revealed bone or joint abnormalities in 10% of individuals. Distinct pathways are available for spread of bacteria which become lodged in the soft tissues of the hand. Such routes include tendon sheaths, fascial planes and lymphatics. An understanding or pertinent anatomy allows the radiologist to predict the site and pattern of soft tissue, articular and osseous alterations.