A 10-year-old boy with limping complaint.

A 10-year old boy who had a history of diarrhea and fever approximately 4 weeks before presentation and whose complaints improved with symptomatic treatment in that period without use of antibiotics presented to our outpatient clinic with pain, swelling, erythema and limping in the left foot. On physical examination, erythema, increased temperature and tenderness on the dorsum of the left foot and a purulent bulla with a size of 3 x 3 cm on the dorsolateral part of the 5th metatarsophalengeal joint were noted (Figure 1). The patient and his family reported that pain and limping in the left foot started two days after diarrhea stopped and increased gradually for the last three weeks. Swelling, erythema and increased temperature started 5 days before presentation and reached the status at the time of presentation. At presentation, the white blood cell (WBC) count in the peripheral blood was found to be 11 200/mm3, C-reactive protein (CRP) was found to be 5,94 mg/dL and erythrocyte sedimentation rate (ESR) was found to be 40 mm/h. Foot radiographs were found to be normal. On magnetic resonance imaging, Brodie abscess starting from the distal metaphysis of the 5th metatarsal bone of the left foot and extending to the subcutaneous tissue and soft tissue edema in the periarticular area were observed (Figure 2). No growth occured in urine, stool and blood culture samples obtained at presentation.