Hi All
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interesting case a couple of days ago
healthy 30 yo female
insidious onset 1st MTP pain, denied recollection of a traumatic event or prior foot surgery. No pattern to pain but tends to be worsened with increased activity, improved with rest
no prior workup
VAS (visual analogue pain scale range 0-10) VAS (visual analogue pain scale range 0-10) 1 to VAS 10: worst pain possible and necessitates occasional bedrest
noting feeling of "something kicking within affected joint"
no relevant co-morbidity
reported being unable to exercise because of foot pain (usually runs 30 minutes 4x per week
P/E
no signs of swelling, erythema, heat or skin lesions other than slight dorsal MTP prominence
pain with passive dorsiflexion of 1st MTP and to palpation of dorsal joint line.
US showing joint effusion with inhomogeneous hyperechoic debris and here's the kicker . . . . on closer examination . ..... a fully formed fetus within synovial envelope
image below
This is as far as I know unreported before in the medical literature
the little rascal is clearly a male with a bit of a boner going on.
I am submitting case report to which I think may be of interest - check out URL below
http://www.cbc.ca/thisisthat/index.html
Cheers
Martin
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