Journal List > J Korean Soc Radiol > v.64(4) > 1086929

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Kim, Lee, Suh, Kang, Hwang, Lee, Min, and Han: Pyogenic Arthritis of the Ankle Joint Following a High-Voltage Electrical Burn in the Lower Extremity: A Case Report
Musculoskeletal Radiology
Case Report

Journal of the Korean Society of Radiology 2011; 64(4): 369-373.

Published online: 30 April 2011

DOI: https://doi.org/10.3348/jksr.2011.64.4.369

Pyogenic Arthritis of the Ankle Joint Following a High-Voltage Electrical Burn in the Lower Extremity: A Case Report

Kuk Seon Kim, M.D., Gyung Kyu Lee, M.D., Kyung Jin Suh, M.D.2, Ik Won Kang, M.D., Dae Hyun Hwang, M.D., Eil Seong Lee, M.D., Seon Jung Min, M.D., You Mie Han, M.D.

Department of Radiology, Hallym University College of Medicine, Hangang Sacred Heart Hospital, Korea.

2Department of Radiology, Dongguk University College of Medicine, Gyeongju Hospital, Korea.

Address reprint requests to: Gyung Kyu Lee, M.D., Department of Radiology, Hallym University College of Medicine, Hangang Sacred Heart Hospital, 94-200 Yeongdeungpo-dong, Yeongdeungpo-gu, Seoul 150-719, Korea. Tel. 82-2-2639-5542, Fax. 82-2-2679-0121, gklee@hallym.or.kr

Received 15 November 2010       Accepted 23 February 2011

Copyright © 2011 The Korean Society of Radiology

Abstract

A high-voltage electrical burn caused extensive deep muscle injuries beneath a relatively small skin wound at the contact point. Hidden, undetected deep muscle injuries have a tendency for progressive tissue necrosis, which can lead to major amputations or sepsis. The radiologic features of this rare, sometimes life-threatening injury have occasionally been described in the literature. However, to the best of our knowledge, there have been no reports on a case of pyogenic arthritis of the ankle joint following a high-voltage electrical burn involving the lower extremity. We report a case of the pyogenic arthritis of the ankle joint following a high-voltage electrical burn involving the lower extremity.

Keywords: Burns, Electric, Arthritis, Infectious, Magnetic Resonance Imaging, Angiography, Lower Extremity

Figures and Tables

Fig. 1

A 38-year-old man with high-voltage electrical burn.

Conventional angiography of the left lower extremity shows complete occlusion of distal anterior tibial and dorslis pedis arteries. There is a normal flow of the posterior tibial artery (arrow).
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Fig. 2

A. Axial T2-weighted (3600/109) turbo spin-echo MR image shows a heterogenous high signal intensity in the entire anterior muscle groups (asterisk) and flexor hallucis longus (FHL) muscle (open asterisk). There is a large anterior defect of the skin and subcutaneous tissue in the distal one-third of the lower leg (arrowhead).

B-D. Gadolinium-enhanced axial (B, C) and sagittal (D) T1-weighted spin-echo MR images obtained with fat saturation show peripheral rim enhancement in the entire anterior muscle groups (asterisks) and part of FHL muscle (open asterisk), representing nonperfused and nonviable areas of edematous muscles. There is diffuse enhancement of FHL muscle (open arrows) at the proximal level, representing perfused and viable area of edematous muscle.
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Fig. 3

Bone scan shows increased uptake in the left ankle joint (arrow).

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Fig. 4

Gadolinium-enhanced sagittal T1-weighted spin-echo MR image obtained with fat saturation shows thick irregular synovial enhancement (asterisks) and marrow enhancement (open asterisks) in the ankle joint, representing pyogenic arthritis.

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References

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