Ulcerative Colitis

Interactive Quiz: Pain and Swelling in the Thigh

  • First, let’s meet the patient …

    A 29-year-old man presented with worsening pain and swelling in the posterior aspect of the right thigh, which had been associated with subjective fever 2 days prior to presentation.

    At presentation, his temperature was 37.9°C, and he had sinus tachycardia of 105 beats/min; all other vital signs were normal.

    The patient had 15-year history of autoimmune hepatitis (AIH) that had been well controlled with immunosuppressive agents 6-MP, sirolimus, and budesonide. His overall health status had been uneventful until 1 week after starting mesalamine therapy for recently diagnosed ulcerative colitis (UC), which had been confirmed by colonoscopy and biopsy.

    A detailed physical examination revealed nonpurulent, nonfluctuating, poorly demarcated, painful swelling in the posterior aspect of the right mid-thigh, with signs of inflammation over the surrounding skin but without an entrance wound. He had no functional limitation despite the painful right thigh.

    Computed tomography (CT) scans of the right thigh were performed.

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    Are you correct? >>