Septic arthritis - ankle

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Painful swelling of the right ankle with fever.

Patient Data

Age: 35 years
Gender: Female
mri

The MRI sequences demonstrate:

  • narrowing of the tibiotalar joint space
  • destruction of the tibial subchondral bone with focal metaphyseal lesions of intermediate signal on T1 and high signal on T2 centrally with hypointense peripheral rim and peripheral enhancement on postcontrast sequences.
  • tibial bone marrow edema surrounding the tibial lesions
  • joint effusion with synovial thickening and enhancement
  • edematous infiltration of the perimalleolar soft tissues

Case Discussion

The clinical presentation and MRI features are most consistent with septic arthritis.

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