Osteomyelitis - fibula

Case contributed by Maulik S Patel


History of leg injury one week ago with plaster applied. Complaining of significant pain for 1 day.

Patient Data

Age: 15 years
Gender: Female

There is diffuse soft tissue swelling abutting distal end of fibula. There is suspicious erosion of distal fibular cortex on lateral aspect. Ankle joint is normal.


Long axis images show collection with mobile echoes abutting distal fibular lateral cortex. It involves subcutaneous plane. Extended field of view shows echogenic subcutaneous fat abutting proximal part of the collection.

There was no ankle joint effusion (image not uploaded).

Case Discussion

Girl presented complaining of swelling, pain, redness of skin on lateral aspect of ankle for 1 day. She had local trauma 1 week back for which immobilization was done. Due to increasing pain, plaster was removed and patient was referred for ultrasound of local swelling. 

Ultrasound shows collection with echoes involving subcutaneous plane - an abscess - abutting fibular cortex. There is secondary involvement of fibula from adjacent soft tissue infection.

Incision and drainage revealed pus.

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