ACTA SCIENTIFIC CLINICAL CASE REPORTS

Case Report Volume 5 Issue 3

The Importance of Early Diagnosis of Septic Arthritis of the Ankle Joint in a Diabetic Patient: A Case Report

Križaj Julija, Janežič Lea Dora and Frangež Igor*

Department of Surgical Infections, University Medical Centre Ljubljana, Slovenia

*Corresponding Author: Frangež Igor, Assistant Professor, Department of Surgical Infections, University Medical Center Ljubljana, Slovenia.

Received: January 31, 2024; Published: February 12, 2024

Abstract

Septic arthritis of the ankle joint is very rare and presents an orthopaedic emergency that can in some cases lead to disability or even death. Here we present a case of a 65-year-old Caucasian male with diabetes mellitus type II, arterial hypertension, peripheral artery disease, hyperlipemia and stage II. chronic kidney disease who developed systemic signs of infection with fever and chills. Magnetic resonance imaging showed a septic tenosynovitis of both flexor hallucis longus and flexor digitorum longus with acquired complications of septic arthritis of the ankle joint and an abscess of the medial malleolus region. The patient was primarily treated with antibiotics, without improvements. Due to a delayed diagnosis and developed complications he later required treatment with multiple invasive surgical procedures. The outcome of the treatment was a successfully eradicated infection and a return of walking ability. Considering the scarcity of reports on management of septic arthritis of the ankle in diabetic patients, this case presents a valuable contribution, highlighting the importance of vigilance in early diagnosis and treatment of such infections for improving patient outcomes.

Keywords: Diabetes-related Foot Infection; Septic Flexor Tenosynovitis; Septic Arthritis of the Ankle Joint

References

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Citation

Citation: Frangež Igor., et al. “The Importance of Early Diagnosis of Septic Arthritis of the Ankle Joint in a Diabetic Patient: A Case Report".Acta Scientific Clinical Case Reports 5.3 (2024): 42-48.

Copyright

Copyright: © 2024 Frangež Igor., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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