A 24-year-old, right-hand-dominant woman presented to the emergency department with a 1-month history of progressive, severe right hand pain localized to the middle finger metacarpal head, with associated swelling. She had no history of fever, chills, significant trauma, puncture wound, or insect bite to the region or arthralgias at other joints. Palpation revealed tenderness and soft-tissue fullness between the index and middle finger metacarpal heads and pain with movement of the middle finger metacarpophalangeal (MCP) joint. Laboratory analysis revealed normal leukocyte count, normal uric acid level, and a mildly elevated erythrocyte sedimentation rate at 29 mm/h (normal range, 0-15 mm/h). Radiographs were obtained and an MRI examination was performed because of clinical concern for infection.
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机译：一名24岁，右手主导的妇女出现在急诊科，有1个月的进行性，严重的右手疼痛史，局限于中指掌指，伴有肿胀。她没有发烧，发冷，严重外伤，穿刺伤口或该区域其他地方被昆虫咬伤或关节痛的病史。触诊显示食指和中指掌头之间有压痛和软组织充盈，中指掌指关节运动导致疼痛。实验室分析显示白细胞计数正常，尿酸水平正常，红血球沉降速率轻度升高，为29 mm / h（正常范围，0-15 mm / h）。由于临床上对感染的关注，因此获得了射线照相并进行了MRI检查。
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