Imaging and Laboratory Workup for Hand Infections

Hand infections can lead to significant morbidity if not treated promptly. Most of these infections, such as abscesses, tenosynovitis, cellulitis, and necrotizing fasciitis, can be diagnosed clinically. Laboratory values, such as white blood cell count, erythrocyte sedimentation rate, C-reactive protein, and recently, procalcitonin and interleukin-6, are helpful in supporting the diagnosis and trending disease progression. Radiographs should be obtained in all cases of infection. Ultrasound is a dynamic study that can provide quick evaluation of deeper structures but is operator dependent. Computed tomographic and MRI studies are useful for evaluating deep space or bony infections and preoperative surgical planning.