Hand and wrist infections can present with a spectrum of manifestations ranging 
from cellulitis to deep-space collections. The various infectious processes can 
be categorised as superficial or deep infections based on their respective 
locations relative to the tendons. Superficial hand infections are located 
superficial to the tendons and are comprised of cellulitis, lymphangitis, 
paronychia, pulp-space infections, herpetic whitlow, and include volar as well 
as dorsal subcutaneous abscesses. Deep hand infections are located deep to the 
tendon sheaths and include synovial space infections, such as infectious 
tenosynovitis, deep fascial space infections, septic arthritis, necrotising 
fasciitis, and osteomyelitis. Knowledge of hand and wrist compartmental anatomy 
is essential for the accurate diagnosis and management of hand infections. 
Although early and superficial infections of the hand may respond to 
non-surgical management, most hand infections are surgical emergencies. 
Multidetector computed tomography (MDCT), with its muliplanar reformation (MPR) 
and three-dimensional (3D) capabilities, is a powerful tool in the emergency 
setting for the evaluation of acute hand and wrist pathology. The clinical and 
imaging features of hand and wrist infections as evident on MDCT will be 
reviewed with emphasis on contiguous and closed synovial and deep fascial 
spaces. Knowledge of hand compartmental anatomy enables accurate 
characterisation of the infectious process and localise the extent of disease in 
the acute setting.