The picture is not doctored. (Heck, a foul wasn't even called.)
With a little searching of the AP and UPI image archives, you'll find more than a few of these types of images from games of basketball & rugby, plus also from the occasional baseball, hockey, and soccer fight.
Also:
John Marsh vs. Sean Scott. In a match were all techniques were allowed, Marsh wrecked Scott's arm after Scott attempts an eye gouge:
http://www.youtube.com/watch?v=_taQXTem_X4
And:
Jordan Raynor vs. John F. Springer:
http://www.bullshido.org/w/images/b/...is_vs._JFS.gif