Case 230

Medical History

VBRS, female pacient, 52 years old, underwent a total left knee arthroplasty 3 years ago. In the early postoperative, presented dehiscence of the surgical wound dress-ings and was treated with oral antibiotics. The patient developed pain refractory to the use of oxycodone. The clinical examination identified pain through mobilization of the left knee joint, local heat and movement of 5-110 ° and limping gait aided by walker. Protein C reactive dosage equal to 20 mg / dL (VR <10mg / dL), VHS and blood test within the reference values.

Image 1: Radiography of the left knee in the incidences anteroposterior and profile.


Image 2: Three-phase bone scintigraphy with 99mTc -MDP- flow phase.


Image 3: Three-phase bone scintigraphy with 99mTc -MDP- blood pool phase in the previous forecast.


Image 4: Three-phase bone scintigraphy with 99mTc -MDP- late whole body and spot images.

Based on the clinical and imaging data, which is the most likely diagnosis?

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