Limits...
Multi-organism osteomyelitis in patient

USU Teaching File MUTF - MedPix

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Multi-organism osteomyelitis in patient

History: 87 y/o woman re-admitted with history of gout of left great toe with persistent bleeding and multiple ulcerations with drainage despite therapy. Past medical history is positive for gout, osteoporosis, hypertension, diabetes mellitus, chronic renal failure and stable angina.

Findings: Radiographs show erosions at the first metatarsophalangeal joint with associated soft tissue swelling. MRI 1.Axial T1 (long axis to forefoot) MR image shows low-signal-intensity inflammatory changes in bone marrow and the soft tissues with destruction of the cortex. 2.Axial T2-weighted with fat sat(long axis to forefoot) MR image shows high-signal-intensity inflammatory changes in bone 3.Post-contrast axial T1(long axis to forefoot) MR image with fat saturation shows enhancing inflammation of the distal and proximal phalanges and surrounding soft tissue and erosions.

Ddx: Osteomyelitis Gout Neurotrophic joint

Exam: Physical examination showed an erythematous, weeping markedly swollen great toe with serous drainage and exposed granulation tissue. The great toe was exquisitely tender to palpation with limited range of movement because of swelling. The patient had decreased cutaneous sensation of distal great toe. Laboratory data showed normal white blood cell count, Na, K, Cr 1.1 with nml serum glucose. Elevated uric acid 8.2.Wound cultures revealed multiple gram negative rods as well C. tetani s/p IG and tetanus booster tx.

No MeSH data available.


© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=MPX1565&req=5


Multi-organism osteomyelitis in patient

USU Teaching File MUTF - MedPix

© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1565&req=5

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Multi-organism osteomyelitis in patient

History: 87 y/o woman re-admitted with history of gout of left great toe with persistent bleeding and multiple ulcerations with drainage despite therapy. Past medical history is positive for gout, osteoporosis, hypertension, diabetes mellitus, chronic renal failure and stable angina.

Findings: Radiographs show erosions at the first metatarsophalangeal joint with associated soft tissue swelling. MRI 1.Axial T1 (long axis to forefoot) MR image shows low-signal-intensity inflammatory changes in bone marrow and the soft tissues with destruction of the cortex. 2.Axial T2-weighted with fat sat(long axis to forefoot) MR image shows high-signal-intensity inflammatory changes in bone 3.Post-contrast axial T1(long axis to forefoot) MR image with fat saturation shows enhancing inflammation of the distal and proximal phalanges and surrounding soft tissue and erosions.

Ddx: Osteomyelitis Gout Neurotrophic joint

Exam: Physical examination showed an erythematous, weeping markedly swollen great toe with serous drainage and exposed granulation tissue. The great toe was exquisitely tender to palpation with limited range of movement because of swelling. The patient had decreased cutaneous sensation of distal great toe. Laboratory data showed normal white blood cell count, Na, K, Cr 1.1 with nml serum glucose. Elevated uric acid 8.2.Wound cultures revealed multiple gram negative rods as well C. tetani s/p IG and tetanus booster tx.

No MeSH data available.