Right lower limb swelling
A male aged 34 years Chief Complaints Right leg erythematous swelling over the medial malleolus with surrounding induration (x 1 month) Physical Examination Local tenderness(+) Temp increased Investigations USG image taken
Symptoms are suggesting the lesion is inflammatory and infective and since 1month so raises many questions 1 we need xray ankle to know underlying bones to r/o osteomyelitis or UN NOTICED BONE INJURY 2 red swelling tender with raised local temp likely GOUT as seen from Usg shows deposits of crystals 3 infective cellulitis needs cbc bsl etc My first dx is GOUT
Do aware of contiguous bacterial spread from skin to ankle joint. Any constitutional symptoms with raised white cell counts should raise the suspicion. Gram stain may help in the selection of antibiotics.
? POST TRAUMATIC CELLULITIS.. ? UNDERLYING BONE..SOFT TISSUE PATHOLOGY.. NEED'S.. X-RAY STUDY.. USG STUDY.. BLOOD..URINE ROUTINE EXAMS.. MEANWHILE TREAT SYMPTOMATICALLY..WITH.. BS..ANTIBIOTICS WITH..NSAIDS AS PER REQUIREMENT..
As the picture shows this seems to be case of cellutitis if the medial aspect of foot. May be due to A underlying any bonny pathology B underlying bacterial infection of the soft tissue C as the USG finding show deposition of crystals or nodular deposition possibility of gouty arthritis to be ruled out though it is not the usual site of gouty arthritis Blood for serum uric acid and routine blood examination and CRP. Blood sugar to see pt is diabetic or not.
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