Case 138

 An eighty two-year-old female presented in our hospital suffering from left wrist joint pain with redness and swelling, and left foot joint pain with swelling and local heat. She had Heberden nodules and Bouchard nodules in bilateral hand digits. Laboratory test revealed no abnormal findings except CRP 5mg/dL, white blood cells 8800/μL. Our orthopedic physician punctured the swollen joint whose fluid contained 6600 cells/μL. She took wrist and foot (Fig. 1) radiographs, and foot MRI (Figs. 2, 3).

What is your diagnosis ?

1. Lisfranc joint injury

2. Chopart’s joint injury

3. Gout

4. Aseptic necrosis

answer

2019.2.20