sepric arthritis/cold abcess a/w osteomyelitis/pyogebic abcess

10 yr old girl with pain tenderness and swelling over lower end of lt leg since 1 yr progessively increase in size.. Usg showa s/o cold abcess with associated oteomylities/ pyogenic abcess.. Fnac would be next better to narrow th diagnosis? Pls suggest ur valuable opinion management plan pls..

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How cum pyogenic abscess is present since 1 year. N patient has survived it . Must b with some divine blessing. Go for cbc crp esr montoux test cxr. Xray of the affected part. Please post the usg film too.

Cold Abscess in lower part of leg is not common site? Ist confirm yr diagnosis before starting tt. X-ray leg FNAC Complete Hemogram Pus C/S test & Z.N.stain for AFB Cold abscess means tubercular origin hence rule out tubercular 1st infection site.?

CBC esr Xrays Please post reports for further comments

I have refered the child for orthopedic evaluation and management..
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Can we start iv antibiotic Or wait for fnac culture..?