Maempel Julian Frederick, Nicol Graeme, Clement Rhys Gareth Ellis, Porter Daniel
Department of Trauma & Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK.
BMJ Case Rep. 2013 Jan 22;2013:bcr2012007473. doi: 10.1136/bcr-2012-007473.
A 29-year-old man presented to his local orthopaedic service with a mass in the medial aspect of his left thigh, present for 1 year. It had not changed in size, although he complained of increasing tightness in the region. He denied any systemic symptoms or history of local trauma. Extensive imaging performed at his local hospital was thought suggestive of a musculoskeletal tumour. The patient was referred to our tertiary centre musculoskeletal tumour clinic. Review of external imaging and further investigations revealed a fluid-filled intramuscular mass containing an echogenic focus consistent with foreign body. Ultrasound-guided aspiration yielded fluid which grew Staphylococcus aureus. Only when presented with this information did the patient vaguely recall sitting on a wooden kebab stick 30 months previously. At surgery, a thick-walled abscess with a central foreign body was identified and drained. At follow-up 1 month later, he was well with no recurrent problems.
一名29岁男性因左大腿内侧出现肿块1年,前往当地骨科就诊。肿块大小未变,但他抱怨该区域的紧绷感日益加重。他否认有任何全身症状或局部外伤史。当地医院进行的全面影像学检查提示可能为肌肉骨骼肿瘤。该患者被转诊至我们的三级中心肌肉骨骼肿瘤诊所。复查外部影像并进一步检查后发现,有一个充满液体的肌内肿块,其中有一个与异物相符的回声灶。超声引导下穿刺抽出的液体培养出金黄色葡萄球菌。直到得知这一信息,患者才隐约回忆起30个月前曾坐在一根木制烤肉扦上。手术中发现了一个有中央异物的厚壁脓肿,并进行了引流。1个月后的随访显示,他恢复良好,没有复发问题。