PMC5694165_01
Clinical image left foot
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PMC5694165_01_40842_2017_48_Fig1_HTML.jpg
Fig1
Seven days post operatively, the patient developed left foot pain, swelling, warmth, and inability to bear weight (Figs. 1 and 2).
Clinical image left foot vs. right foot
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Fig2
Seven days post operatively, the patient developed left foot pain, swelling, warmth, and inability to bear weight (Figs. 1 and 2).
X-ray left foot
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Fig3
There was radiographic evidence of soft tissue swelling with no findings concerning for osteomyelitis or Charcot neuroarthropathy (Figs. 3, 4, 5).
X-ray left foot
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Fig4
There was radiographic evidence of soft tissue swelling with no findings concerning for osteomyelitis or Charcot neuroarthropathy (Figs. 3, 4, 5).
X-ray left foot
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PMC5694165_01_40842_2017_48_Fig5_HTML.jpg
Fig5
There was radiographic evidence of soft tissue swelling with no findings concerning for osteomyelitis or Charcot neuroarthropathy (Figs. 3, 4, 5).
Dermal thermometry values. Abbreviations: MT metatarsal; TNJ talonavicular joint; CCJ calcaneocuboid joint; CN Charcot Neuroarthropathy. Legend: vertical stripes left foot; horizontal stripes right foot; solid line charcot neuroarthropathy temperature levels
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PMC5694165_01_40842_2017_48_Fig6_HTML.jpg
Fig6
Dermal thermometry was performed bedside and the recordings (Fig. 6) were analyzed according to work of Armstrong et al. and Najafi et al.
CT scan left foot
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Fig7
On further assessment and review of recent parathyroidectomy surgical history, podiatry recommended a CT scan (Fig. 7) for evaluation of the underlying osseous structures, an endocrinology evaluation due to patient's persistent hypocalcemia, and a rheumatology consult for evaluation for pseudogout.
Peri-operative serum calcium levels. Legend: solid line patient values; dashed points minimum normal values; dotted points maximum normal values
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Fig8
After beginning pharmacologic treatment as recommended by both the endocrinology and rheumatology teams, calcium levels began to slowly normalize (Fig. 8) and patient's left foot pain began to decrease.