Mycetoma of the hand

OBJECTIVE: To describe the incidence and radiographic signs of hand infection in mycetoma. METHODS: A retrospective review was carried out from the radiographic records of 516 confirmed cases of mycetoma seen between January 1994 and October 2002 at the referred outpatient clinic of the Mycetoma Research Center, Soba Teaching Hospital, Khartoum University, Khartoum, Sudan. RESULTS: The hands were involved in 24 (4.6%) of the 516 patients. The wrist was involved in 9 (1.7%). Total involvement of the hand and wrist together was 33 (6.4%) of the 516 patients. Radiographic signs included fanning of the metacarpals, bone erosions, sclerosis, periostitis and soft tissue swelling. The most common sign was soft tissue swelling in 29 (88%) while bones were involved in 15 (45%) of the 33 patients. CONCLUSION: Hand infection in this series is less than previous reports. A wide range of radiographic signs is reported in hand mycetoma. This is the first detailed report of the radiographic findings in mycetoma of the hand. Early detection of mycetoma infection is important to avoid the need for amputation if diagnosis is delayed.