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A giant soft tissue sinus in the leg.
1Medical Department, Combined Military Hospital, Pano Aqil.
Summary
A persistent leg soft tissue sinus, initially treated for tuberculosis, required complete excision after imaging revealed its extensive nature. This case highlights the diagnostic value of sinography for complex sinus tracts.
Area of Science:
- Orthopedic Surgery
- Diagnostic Imaging
Background:
- Soft tissue sinus tracts can present diagnostic challenges, particularly when they persist after initial treatments.
- Chronic inflammation mimicking tuberculosis can complicate the diagnosis and management of sinus tracts.
Observation:
- A large soft tissue sinus in the leg, following minor trauma, persisted despite two excisions and anti-tuberculosis therapy.
- Histopathology suggested chronic inflammation potentially due to tuberculosis, guiding initial treatment.
- A sinogram demonstrated an extensive sinus tract from the ankle to the fibular head.
Findings:
- Sinography proved crucial in defining the full extent of the sinus tract.
- Intraoperative methylene blue outlining aided complete surgical excision.
- Complete excision of the large sinus tract led to permanent healing.
Implications:
- Sinography is a valuable tool for diagnosing and managing extensive soft tissue sinus tracts.
- Accurate delineation of sinus tracts is essential for successful surgical outcomes.
- This case underscores the importance of comprehensive diagnostic imaging when initial treatments fail.