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Imaging Diagnosis

The radiographic features of ainhum reflect the pathological and anatomical changes already described. On radiographs with good soft tissue detail the prominent groove in the soft tissues of the affected digit will usually be visible as a constriction around its base (Figs. 37.6-37.8).

Fig. 37.6 Ainhum in a 68-year-old black woman from Louisiana with a 3 year history of a gradually constricting band involving the fifth toe. The characteristic groove is well defined and there has been pressure resorption of the distal shaft and head of the proximal phalanx and most of the middle phalanx. (Courtesy of Dr. Lawrence Fetterman, Mobile).

Fig. 37.7 Ainhum in an African patient showing the constricting groove near the base of the fifth toe with pressure resorption of the distal shaft of the underlying proximal phalanx. (Courtesy of the late Dr. Harold Jacobson).

Fig. 37.8 Ainhum in a patient from India. Note the marked constricting ring encircling the base of the fifth toe with virtually complete resorption of the middle phalanx and the shaft and head of the proximal phalanx, as well as part of the base of the distal phalanx. Such advanced destruction may progress to auto-amputation or necessitate surgical amputation of the digit. (Courtesy of Dr. A. Chandrahasan Johnson).

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