 | Viet Tran A 34yo female comes in with painful mobilisation in the context of "bilateral idiopathic cellulitis" diagnosed by the naturopath 4 weeks ago & treated with myrtle flowers brewed in a clockwise direction. |
Clinically she appears thin, well, and in a moderate amount of pain.
Her legs look swollen with haemoserous weeping on the anterior aspects of her shins. There is also surrounding erythema and the entire lower legs, bilaterally, are exquisitely painful. Distally she is neurovascularly intact and there is no clinical concern of a lower leg compartment syndrome.
X-rays were requested given the unusual presentation and broad list of differentials:
Her legs look swollen with haemoserous weeping on the anterior aspects of her shins. There is also surrounding erythema and the entire lower legs, bilaterally, are exquisitely painful. Distally she is neurovascularly intact and there is no clinical concern of a lower leg compartment syndrome.
X-rays were requested given the unusual presentation and broad list of differentials:
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What do the X-rays show?
There are AP and lateral views of both lower limbs.
There is bilateral pretibial soft tissue swelling and generalised subcut oedema
There is extensive bone destruction/resportion and reparation with periostitis involving the anterolateral margin of both tibias R > L
These are centred on the midshaft
This is all consistent with osteomylitis.
She needs to switch the myrtle for the PICC & enjoy.
There is bilateral pretibial soft tissue swelling and generalised subcut oedema
There is extensive bone destruction/resportion and reparation with periostitis involving the anterolateral margin of both tibias R > L
These are centred on the midshaft
This is all consistent with osteomylitis.
She needs to switch the myrtle for the PICC & enjoy.
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