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Download the article PDF: Clinical Image Challenge February 2026
A 64-year-old female presents to urgent care complaining of right thumb pain. The patient states she removed a wooden splinter from her thumb herself about 2 weeks prior, she denies any other trauma or systemic symptoms. The patient has a history of Type II diabetes and her last A1C 2 months prior was 9.3.
Physical examination reveals the patient is afebrile with normal vital signs. There is a small, scabbed wound on the palmar surface of the thumb and moderate tenderness, induration, edema and erythema are noted surrounding the wound. There is a faint linear extension of erythema up to the metcarpophalangeal joint. She has decreased interphalangeal joint range of motion. Sensation is intact and capillary refill is brisk. Radiographs are ordered.
View the x-ray images taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
