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Hand Cellulitis

Dr. Oron Frenkel, MD

Distinguish abscess from cellulitis by identifying “cobblestone” edema in the subcutaneous and dermal tissues of the dorsal hand.

Specialties: Emergency Medicine, MSK, Primary Care, Rural
Applications: MSK, Superficial
this is a scan with a linear transducer on a shallow depth placed on the dorsum of the hand as we can see these bright white lines below represent the metacarpal bones and so all this tissue is the [Music] subcutaneous tissue with a lot of dark hypoechoic appearing fluid that is tracking through some of the fascial planes but also in the subcutaneous and the dermal tissue here as we scan through we can see the circular vascular structures that if you put color on would light up with appropriate doppler flow these findings suggest most likely cellulitis but other causes of vasogenic edema such as venous insufficiency or a proximal obstruction can cause a similar appearance on ultrasound you

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