PMC9749414_01
X-Ray examination of the patient on admission. (A and B) Coronal and sagittal radiographs demonstrated collapsed articular surfaces and narrowed joint spaces in the talus bone.
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Anteroposterior and lateral X-ray of the right ankle showed arrowed joint spaces (Figure 1A and B).
CT examination of the patient on admission. (A and B) Coronal CT showed bone destruction at the lower part of the right tibia, and the articular surface of the right talus collapsed). (C and D) Axial CT showed multiple cystic bone destruction below the articular surface of the right ankle, with obvious destruction of the medial malleolus.
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CT showed multiple cysts were noted below the articular surface of the right ankle, and the articular surface of the talus collapsed (Figure 2A-D).
MRI examination of the patient on admission. (A and B) Sagittal T1T2-weighted image shows an abnormal signal, a narrowing of the right ankle joint, and coarse articular surfaces. (C and D) Axial image shows erosion and destruction of the medial and medial malleolus of the talus, with multiple cystic changes.
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MRI showed the right ankle joint space was significantly narrowed, the articular surface was coarse, the articular cartilage was thinned, the talus articular surface collapsed, and multiple cysts were found in the subchondral bone (Figure 3A-D).
Brucella melitensis was detected by real-time PCR, real-time PCR showed that the DNA content of Brucella melitensis (Dotted red line) increased in 27 cycles.
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Joint synovial fluid of right ankle was extracted by joint aspiration and sent to the laboratory for Real-time PCR examination, and the results showed that there was B. melitensis in the synovial fluid (Figure 4).
Pathological staining of right ankle joint effusion and inflammatory tissue. (A) Inflammatory cell infiltration was seen by HE staining. (B) Acid-fast staining was negative.
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The HE staining of ankle fluid revealed inflammatory cell infiltration, while acid-fast staining was negative (Figure 5A and B).