HPI - A 57 year old patient presented to ER with a 1-day history of right elbow posterior erythema and warmth on 27/02/2017.
Diagnosis: septic olecranon bursitis. Oral antibiotic prescribed.
The second day (28/02/2017). More warmth and erythema with pain and fever. Went back to the ER again.
An incision was made at the tip of olecranon and drained 5mL yellow liquid, sent to lab for analysis.
Lab report: Gram-positive coccus seen. Continue oral antibiotics and went home.
The third day(1/03/2017), more pain with high fever, the olecranon and the whole forearm swollen, erythema and warmth. The patient presented to Orthopaedic Clinic.
Surgical debridement and bursa excision was done. Intra-op found a lot of white spots as shown in the pictures.
The patient's general condition and arm condition got better quickly post-operatively.
Intra-op tissue pathology result showed: septic bursitis
The post-op diagnosis: septic bursitis + pseudogout?
Post-op oral antibiotics and Colchicine were prescribed.
However, pt had wound nonunion with liquid drainage. Liquid sent to lab twice: no bacteria, normal WBC, no sign of infection.
What is the diagnosis?
HPI - pain and swelling staretd gradually two monthes earlier
pain excaserbate with standing walking activity and settle with rest and pain killer
What is the most likely diagnosis?
HPI - History of closed mid-diaphyseal fracture of the left femur whitch was treated by ORIF nine months ago
There was chronic wound discharge after the operation for three months treated by oral antibiotics
Investigations of deep infections are positive
What is the cyst noted in the pre op x ray
HPI - 30 year old right hand dominant male with AML on chronic immunosuppression, status post multiple repeat I&D of multiple joints, including right elbow, for septic arthritis and subsequent osteomyelitis. Status post left TKA due to septic arthritis, uses wheelchair for mobility. Right elbow antibiotic spacer has been in for 1 year.
What should be the next step in management?
HPI - swelling both lower legs for 1 year, worse by long standing and walking, no significant pain.
Based on the images provided, what do you think is the most likely cause of the edema?
HPI - 20M injured foot
How would you classify this fracture?
HPI - 60 year old male, household ambulator previously, confined to the bed for past 2 years, complained of pain in his right hip when he sat on a chair.
How would you manage this patient ?
HPI - fall from height 4 feet
orif plate and screws with bone graftin or screws (raft tech)& bone grafting