Bad To The Bone: A Piercing Case Of Anterior Shin Pain

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Bad To The Bone: A Piercing Case Of Anterior Shin Pain - Page #3

Lab Studies: X-rays of the right tibia/fibula (Lateral, AP views) showed no evidence of fracture but did reveal a small hypoechoic area at the medial distal tibia. Bilateral lower extremity venous duplex showed no superficial or deep vein thrombosis or arteriovenous malformation but did reveal a 3.5 mm perforator vessel at the medial tibia emptying into the posterior tibial vein without reflux. MRI of the right tibia/fibula confirmed a varicose vein perforating the medial cortex of the distal tibial diaphysis. No fractures or pathologic bone marrow infiltration. Case Photo #1 Consultations: Vascular surgery Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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