Ankle Pain In A Street Hockey Player - Page #3

Lab Studies:
Initial Case Photo #1: Minimal lateral soft tissue swelling. Triangular lucency at the distal fibular metaphysis.

Two months later Case Photo #2: Increase in size of lucency in the distal metaphysis with new linear periostitis.

MRI,: Enhancing lesion at the distal fibula with evidence of Brodie’s abscess superior to the distal fibular physis, as well as a possible chronic infection.

Bones Scan Case Photo #6, Case Photo #7: Linear uptake in the distal right fibula.

CT-Guided Bone Biopsy Case Photo #8,: Osteolytic lesion of the distal fibula.

Sterile Biopsy Results:
Escherichia Coli - Ciprofloxacin (sensitive)
Klebsiella oxytoca – Ciprofloxacin (sensitive)
Klebsiella pneumoniae – Ciprofloxacin (sensitive)
Shigella sonnei (subgroup D) – Ciprofloxacin (sensitive)

Other Studies:
Admission Labs:
WBC: 4.47
ESR: 9
CRP: 0.8
ANA: +1:160 (nucleolar pattern)
Stool Culture - Negative
HIV- negative

Infectious Disease

Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.

NOTE: For more information, please contact the AMSSM, 11639 Earnshaw, Overland Park, KS 66210, (913) 327-1415.

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