Presentation
History of long-distance walking one month back. Followed by difficulty in walking. Presented with an inability to walk for the last one day.
Patient Data
To rule out femur neck fracture/hip bone fracture - a radiograph of the pelvis and both hip joints was requested. Osteopenia with left-sided pelvic tilt. No fracture.
Deep venous thrombus was suspected as the patient was much less mobile for the last one month and leg edema was present.
No deep venous thrombosis in common femoral/superficial femoral/popliteal / paired anterior tibial / paired posterior tibial veins.
The last two images show a fracture of the proximal shaft of the tibia - at the site of pain pointed by the patient. Local hypervascularity is present.
An incomplete fracture of the proximal tibial shaft sparing the lateral cortex. No periosteal reaction/ bone lesion/ dislocation.
Case Discussion
This is a case of leg pain, edema without significant recent trauma. The investigations uploaded here are in the actual sequence.
Once the scan for DVT was negative, an ultrasound probe was placed at the site of pain pointed by the patient which revealed a fracture of the tibia. A radiograph was done later.
Scanning the area of pain is very important which may be done at the beginning or at the end of the scan depending on your preference.
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