Presentation
Proximal medial leg pain, swelling, and skin redness for the last few days. Proximal tibial screw and plate fixation two years ago.
Patient Data
Moderate effusion with mild synovial thickening involving the left suprapatellar recess. Collection with mobile internal echoes in the anteromedial proximal leg extending from the subcutaneous plane to the tibial cortex and plate screw. Collection about 125 (craniocaudal) x 50 (axial) x 20 (anteroposterior), 66 cc. No collection along the anterolateral proximal tibial plate screw fixation. Reverberation artifact due to plate and screw fixation.
Case Discussion
The patient with an old proximal tibial plate and screw fixation showed proximal medial leg inflammation. Ultrasound revealed suprapatellar effusion, synovial thickening, and abscess around the proximal medial tibial plate.
Surgery revealed pus along the anteromedial proximal tibial plate and screw without abscess extension in the knee joint. Suprapatellar effusion was reactive on aspiration. There was no pus along the anterolateral plate and screw. Both medial and lateral plate and screw were removed.
Operative findings courtesy: treating surgeon Dr. Piyush Patel
A companion case of femur osteomyelitis: rID-149541