Atraumatic Ankle Swelling - A Unique Southwestern Origin

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Atraumatic Ankle Swelling - A Unique Southwestern Origin - Page #3

Lab Studies: CBC: WBC mildly elevated at 12.8, otherwise normal CMP:normal Uric Acid: 4.4 CRP: 5.3 Sedimentation Rate: 11 Other Studies: Xray of right ankle: no fractures, no arthrosis, no destructive lesions. There is medial ankle soft tissue swelling, possible tibiotalar joint effusion. Case Photo #6 , Case Photo #7 , Case Photo #8 MRI: chronic thickening of the anterior talofibular and anterior inferior tibiofibular ligaments. There was also soft tissue edema as well as fluid in the posterior tibial and flexor digitorum tendons but no abscess. No joint effusion.[Photos 1]. Case Photo #2 . Case Photo #3 Ultrasound: fluid collection in the posterior tibial tendon sheath and flexor digitorum tendon sheath. In addition, the posterior tibial tendon and flexor digitorum tendons were thickened to 7 mm with normal echogenicity Case Photo #4 Case Photo #5 Consultations: None. Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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