An Unusual Case Of Chronic Knee Pain In A Mountain Biker

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An Unusual Case Of Chronic Knee Pain In A Mountain Biker - Page #3

Lab Studies: Arthrocentesis showed hazy fluid which had 4,700 White Blood Cells (WBCs), predominately lymphocytes and monocytes. Fluid culture yielded no growth. Coccidioides IgG and IgM reactive. Complement fixation titers 1:16. CBC, ESR, CRP, rheumatoid factor, CCP and Lyme antibody testing negative. Other Studies: MRI of the left knee without contrast showed moderate knee effusion, large popliteal cyst with inhomogeneous soft tissue within the cyst, along with extensive synovitis. Case Photo #2 Left popliteal mass sent for pathology, which showed necrotizing granulomatous inflammation. GMS stain consistent with coccidioidomycosis. Consultations: Orthopedic Oncology Infectious Disease Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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