Besinger Bart, Ryckman Sydney
Indiana University School of Medicine, Department of Emergency Medicine, Indianapolis, Indiana.
Clin Pract Cases Emerg Med. 2021 Feb;5(1):97-100. doi: 10.5811/cpcem.2020.12.50299.
Septic malleolar bursitis is a rare cause of ankle pain and swelling. It has been described in certain occupational and recreational activities that involve tight-fitting boots, such as figure skating. Court-ordered electronic monitoring devices are often worn on the ankle. It is not known whether these devices are a risk factor for the development of malleolar bursitis.
We describe a 41-year-old male under house arrest with an electronic monitoring device on his right ankle who presented to our emergency department with several days of progressive pain and swelling over the medial malleolus. Point-of-care ultrasound revealed a thick-walled cystic structure consistent with medial malleolar bursitis. Bursal aspiration was performed. Fluid culture yielded Staphylococcus aureus.
Emergency physicians regularly see patients with ankle pain and swelling and must consider a comprehensive differential diagnosis. Septic malleolar bursitis is an uncommon but important cause of ankle pain and swelling that requires prompt diagnosis and intervention. Point-of-care ultrasonography may aid in the diagnosis. Additionally, emergency physicians should be aware of potential complications related to electronic monitoring devices.
化脓性踝关节滑囊炎是踝关节疼痛和肿胀的罕见原因。在某些涉及紧靴的职业和娱乐活动中曾有相关描述，如花样滑冰。法庭下令佩戴的电子监测设备常戴在脚踝上。目前尚不清楚这些设备是否是踝关节滑囊炎发生的危险因素。
我们描述了一名41岁居家监禁男性，其右脚踝佩戴电子监测设备，因内踝处持续数天的进行性疼痛和肿胀前来我院急诊科就诊。床旁超声显示一个厚壁囊性结构，符合内踝滑囊炎表现。进行了滑囊穿刺抽吸。液体培养检出金黄色葡萄球菌。
急诊医生经常会接诊踝关节疼痛和肿胀的患者，必须考虑全面的鉴别诊断。化脓性踝关节滑囊炎是踝关节疼痛和肿胀的一种罕见但重要的原因，需要及时诊断和干预。床旁超声检查可能有助于诊断。此外，急诊医生应意识到与电子监测设备相关的潜在并发症。
