Presentation
History of total knee replacement 5 months ago, suffering now from knee stiffness and painful swelling at upper knee extent with fever.
Patient Data
Multiple lucencies at the medial lower thigh aspect.
Post knee replacement with metallic hardware prosthesis.
There are changes related to total knee replacement with metallic hardware prosthesis showing metallic beam hardening artifact.
The lower thigh cuts revealed deeply seated intramuscular heterogenous collection at the anteromedial aspect of the lower thigh associated with calcified periosteal reaction of the underlying distal femur.
The collection mainly involves vastus intermedius muscle abutting supra-patellar synovial recess with multiple gaseous foci inside associated with blurring of the surrounding fat planes.
Case Discussion
These findings are suggestive of an inflammatory process involving a deep muscular compartment with a localized collection and showing gaseous foci indicating likely abscess formation.
Contributed by Dr Walid Said Aboshanab.