Curriculum · Musculoskeletal / Orthopedic / Rheumatology
Calf pain after knee arthroplasty
What it is
A 65-year-old woman complains of low-grade fever and calf pain 2 weeks following a total knee arthroplasty, and the next step in management is what is asked. The four steps put beside each other are knee aspiration for a septic joint, CT angiography of the lower extremity, venous ultrasound, and MRI of the leg. So the calf after an arthroplasty is a place where a septic joint and a clot are held in mind together, and the imaging that separates them is the point of the case.
How it is diagnosed
The picture that goes with a clot is a 3-day history of progressive leg swelling with right leg swelling up to the knee, redness and calf tenderness, in a patient on oral contraceptive pills; DVT is what is suspected there. The two differential diagnoses given for unilateral limb swelling are cellulitis and rupture of a Baker's cyst. The imaging modality of choice to confirm the diagnosis is US Doppler.