J Korean Foot Ankle Soc.  2019 Jun;23(2):67-70. 10.14193/jkfas.2019.23.2.67.

Native 1st Metatarso-Phalangeal Joint Infection: A Rare Case Report

• Iliopoulos E
• Hossain N
• Bendall S

• KMID: 2449674
• DOI: http://doi.org/10.14193/jkfas.2019.23.2.67

Abstract

Septic arthritis is a serious medical condition that can lead to significant complications if misdiagnosed or mismanaged. A rare case of a 1st metatarso-phalangeal joint septic arthritis in a native joint is presented in a patient with no significant risk factors. A 41-year-old patient was referred by his general practitioner owing to ongoing pain and swelling over his native 1st metatarso-phalangeal joint with difficulty on weightbearing for three months. After a series of investigations, including blood tests and a foot magnetic resonance imaging, which were inconclusive, the patient was led to the operating theatre for sampling and washout of his joint. The samples taken in the theatres revealed septic arthritis with Streptococcus mitis as the causative microorganism. The patient was treated with six weeks of oral antibiotics with a good functional outcome. This case report illuminates this rare condition and makes foot and ankle surgeons aware of its existence. A high suspicion for this condition can prevent misdiagnosis and mismanagement.

Keyword

Pseudopodagra; Infectious arthritis; Joints; Foot; Infection; Streptococcus mitis

MeSH Terms

Adult
Ankle
Anti-Bacterial Agents
Arthritis, Infectious
Diagnostic Errors
Foot
General Practitioners
Hematologic Tests
Humans
Joints*
Magnetic Resonance Imaging
Risk Factors
Streptococcus mitis
Surgeons
Weight-Bearing
Anti-Bacterial Agents

Figure

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  Figure 1 Anteroposterior (A) and oblique (B) plain radiographs at the time of presentation.

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  Figure 2 T2 sequence of the magnetic resonance imaging scans of the affected foot show the bone marrow oedema. (A) Axial view, (B) sagittal view.

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