When Love Makes You Limp: An Unusual Case Of Ankle Pain In A High School Athlete

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When Love Makes You Limp: An Unusual Case Of Ankle Pain In A High School Athlete - Page #3

Lab Studies: Complete blood count (CBC) was notable for mild leukocytosis of 13.9 x 103 cells/microliter. C-reactive protein was elevated at 62 milligrams/liter, however erythrocyte sedimentation rate was normal at 15 millimeters/hour. Urinalysis revealed sterile pyuria. Synovial fluid analysis showed grossly purulent fluid with 85,200 total nucleated cells, 85% neutrophils, no organisms on gram stain, and negative culture. Urine antigen testing was positive for both gonorrhea and chlamydia. Other Studies: Radiographs of the left ankle showed no evidence of fracture or malalignment and joint spaces were maintained, A small ossicle was noted adjacent to the lateral malleolus, and favored to be related to remote trauma Case Photo #1 . Point-Of-Care Ultrasound of the left ankle revealed a large tibiotalar joint effusion Case Photo #2 . Consultations: Orthopedics was consulted for further management of presumed gonococcal septic arthritis of the left ankle. Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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