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Foot Ankle Surg. 2012 Mar;18(1):e12-5. doi: 10.1016/j.fas.2011.10.002. Epub 2011 Nov 1.

Acute staphylococcal hind foot osteomyelitis in a healthy adult: A case report.

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  • 1Department of Orthopaedics, Medway Foundation NHS Trust, Gillingham, Kent, United Kingdom.



Acute osteomyelitis of the hind foot is uncommon in a normal immunocompetent adult.


We present a previously healthy 52 year old caucasian male who developed painful swelling of his ankle/hindfoot following closed soft tissue football injury. He had no antecedent systemic symptoms. Magnetic resonance imaging and bone scan imaging, followed by surgical decompression and bone biopsy confirmed a diagnosis of Staphylococcus aureus hind foot osteomyelitis. He underwent triple fusion after debridement and had suppressive antibiotics. His pain and swelling resolved at 6 weeks postoperation and CT confirmed fusion at 6 months. His inflammatory markers normalised over the course of 7 months. After 18 months, he remained asymptomatic without any evidence of recurrence.


This case represents an unusual and important variation of presentation of acute osteomyelitis in a healthy adult. It can be easily overlooked when a normal patient presents with pain and functional impairment after a closed soft tissue trauma, but a high index of suspicion is paramount because virulent organisms can infect immunologically normal patients.

Copyright © 2011 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

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