H-grade fever associated with pain and swelling involving mid/distal leg on medial aspect as well as medial ankle region. Tibial and fibular screw and plate fixation 4 months ago.
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There is a collection with mobile echoes abutting entire length of the tibial plate. The maximal anteroposterior thickness of the collection is up to 10 mm in the distal leg and up to 5 mm proximally.
There is no collection along the fibular plate. There is no ankle effusion. There is diffuse subcutaneous edema involving the medial leg and ankle region.
Patient presented with fever, pain and swelling involving medial leg and ankle. Recent history of tibial and fibular internal fixation with screw and plate. No infective symptoms since operation and no concerns about the surgical site. The patient was referred to differentiate cellulitis versus abscess.
Ultrasound showed an abscess formation abutting the tibial plate. Blind aspiration by treating orthopaedic surgeon revealed pus and culture grew Staphylococcus aureus.