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Age / Sex : 12 / F
Chief complaint: painful swelling of right ankle for 4 days
1) What is your impression?
Two weeks later, you can see the final diagnosis with a brief discussion of this case.
(Quiz는 quiz일 뿐이오니 답안은 한개만 보내주시기 바라오며, 복수의 답안을 보내주시는 분은 정답이 포함되어 있더라도 부득이 semi-correct answer로 처리토록 하겠습니다.)
Courtesy: 이지영(Lee Jee Young), 단국대병원(Dankook University Hospital)
Diagnosis: Acute osteomyelitis of distal tibia and septic arthritis in the right ankle
Discussion
Findings:
Simple
radiographs showed periarticular soft tissue swelling in the right ankle. There
were no focal bone lesions in the simple radiographs. Ultrasonograms showed
periosteal fluid collection in the distal tibia and echogenic fluid in the
ankle joint. MR showed osteomyeltis in the distal tibial metadiaphysis with
physeal and subperiosteal abscess, Periosteal abscess around the disatl tibia
drained to the ankle joint.
Diagnosis:
Acute osteomyelitis of distal tibia
and septic arthritis in the right ankle
Discussion:
Arthroscopic debridement
and irrigation were performed. Large amount of yellowish turbid pus and
periosteal perforation were identified. Culture from the pus fluid resulted in
the the growth of S. aureus.
References:
1:
Resnick D. Diagnosis of bone and joint disorders. Saunders,
2002, 4th ed. 2375-2624
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