Endres Stefan, Quante Markus
Department of orthopaedic surgery Elisabeth-Klinik GmbH Bigge/Olsberg, Heinrich-Sommer-Str, 4, 59939 Olsberg, Germany.
J Med Case Rep. 2007 Jul 9;1:44. doi: 10.1186/1752-1947-1-44.
We report the case of a healthy 36 year old man who suffered from foot pain lasting for weeks, without having a specific medical history relating to it. The clinical evaluation was interpreted as a transfer metatarsalgia caused by a splayfoot. The radiographs revealed no pathology except the splayfoot deformity. Due to persistent pain and swelling of the entire forefoot, after two weeks of conventional treatment, magnet resonance images (MRI) and a blood sample were taken. The laboratory investigation showed raised levels of white blood cell count and C-reactive protein. The MRI showed up oedema in the metatarsal heads II-IV, as well as soft tissue swelling of the forefoot without any signs of decomposition.Because of this atypical inflammation of the forefoot a laboratory investigation to check for rheumatology disease was done and revealed borrelia burgdorferi infection. On the basis of these findings, antibiotic treatment was started and maintained over three weeks. The symptoms disappeared after 2 weeks, and the patient was able to resume his sports activities.
我们报告了一名36岁健康男性的病例，他足部疼痛持续数周，无相关特殊病史。临床评估认为是扁平足导致的转移性跖痛症。X光片除显示扁平足畸形外未发现其他病变。由于整个前足持续疼痛和肿胀，在进行两周的常规治疗后，拍摄了磁共振成像（MRI）并采集了血样。实验室检查显示白细胞计数和C反应蛋白水平升高。MRI显示第二至第四跖骨头出现水肿，以及前足软组织肿胀，无任何分解迹象。由于前足的这种非典型炎症，进行了实验室检查以排查风湿性疾病，结果显示感染了伯氏疏螺旋体。基于这些发现，开始了为期三周的抗生素治疗。症状在两周后消失，患者能够恢复体育活动。
