Presentation
Complaint of joint swelling, pain since 1 month.
Patient Data
Limited CT acquisition of patella shows an osteolytic area with central sclerotic focus representing sequestrum.
Patellar osteomyelitis with osteolytic lesion noted in lateral half of patella with associated cortical destruction and a communicating fistulous tract extending into large circumscribed complex subcutaneous collection noted along the lateral aspect of thigh and knee joint and persistently hypointense area with sclerosis noted within the osteolytic area representing sequestrum.
Also noted is the distention of prepatellar and superficial infrapatellar bursa with synovial thickening in keeping with septic bursitis.
Mild to moderate joint and supra patellar synovial effusion with hypointense synovial thickening and capsular distention and associated patchy marrow edema seen predominantly in intercondylar notch, medial and lateral condyles of femur in keeping with infective synovitis.
Case Discussion
Sequestrectomy and debridement were performed and intra-operatively approx. 300 mL pus was drained, and laboratory parameters were positive for tuberculous, and patient was put on anti-tubercular therapy with significant relief of symptoms on 6-week follow-up.
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