PMC7071934_01
A. Sagittal ultrasound image of the affected left ankle flexor tendons near the medial malleolus demonstrating synovial fluid collection above and below the tendon was demonstrated. B. Sagittal magnetic resonance image of the affected left ankle flexor tendons near the medial malleolus demonstrating synovial fluid collection above and below the tendon was illustrated. C. Sagittal ultrasound image of the affected flexor tendon sheath demonstrating circumferential synovial fluid collection was displayed. D. Sagittal magnetic resonance image of the affected flexor tendon sheath demonstrating circumferential synovial fluid collection was shown. Index: "x" identifies the tendon. "^' identifies the tendon sheath. "*" Identifies the tendon sheath fluid
bet-8-041-g001.jpg
PMC7071934_01_bet-8-041-g001.jpg
F1
Point of care ultrasound performed by the emergency physicians demonstrated minimal soft tissue edema; however, there was significant amounts of fluid around the synovium of the flexor tendons at the medial ankle, which was concerning for tendon sheath infection (Figure 1A and 1C).  A magnetic resonance imaging (MRI) study was subsequently ordered by orthopedic surgeons preoperatively, which demonstrated tenosynovitis of the left ankle flexor tendons, most pronounced in the posterior tibialis tendon sheath (Figure 1B and 1D).
PMC7071934_02
A. Photograph of affected Right Thumb was shown. B. Sagittal volar ultrasound image of the affected digit demonstrating synovial fluid collection above and below the tendon was demonstrated. C. Transverse volar ultrasound image of the affected digit demonstrating circumferential synovial fluid collection was illustrated. Index: "x" identifies the tendon. "^' identifies the tendon sheath. "*" Identifies the tendon sheath fluid
bet-8-041-g002.jpg
PMC7071934_02_bet-8-041-g002.jpg
F2
There was only mild soft tissue edema noted around the thumb (Figure 2A). Point of care ultrasound performed by the emergency physicians demonstrated fluid surrounding the extensor tendon (Figures 2B and 2C).
PMC7071934_03
A. Volar photograph of affected right hand was shown. B. Sagittal volar ultrasound image of the affected digit demonstrating synovial fluid collection above and below the tendon was displayed. C. Dorsal photograph of affected right hand was demonstrated. D. Sagittal dorsal ultrasound image of the affected digit demonstrating synovial fluid collection above and below the tendon was illustrated. Index: "x" identifies the tendon. "^' identifies the tendon sheath. "*" Identifies the tendon sheath fluid
bet-8-041-g003.jpg
PMC7071934_03_bet-8-041-g003.jpg
F3
Examination of the right hand revealed significant swelling over the dorsal aspect of the right hand and wrist with an edematous and erythematous fifth digit (Figures 3A and 3C). ED point of care ultrasound demonstrated mild soft tissue edema; however, significant fluid surrounding the flexor tendon of the fourth digit was noted (Figures 3B and 3D), and thus increased concern for pyogenic tenosynovitis.