Tomorrow will be a 2nd look surgery on what we are tentatively calling a hemorrhagic bursitis secondary to (possibly) a tuberculosis induced xanthogranuloma in a 50-something year old native lady.

She originally presented with the elbow you see below, told us that it had blown up like this six days prior.


2.jpg


Obese, slightly hypertensive, otherwise negative ROS.

Surgery was done under supraclavicular and a little versed.

Here's what came out when we made incision:

http://instagram.com/p/nYtNjzIein/

A large amount of really thick bursal tissue came out as well.

We washed her out, closed her up. The next morning her elbow looked exactly the same....filled right back up, just as large. We decided not to go in again until we knew what we were dealing with.

Biopsies have taken a couple weeks........we've actually gotten some input from some well regarded pathologists in the states. The histology dx- xanthogranuloma - doesn't make much sense.

Anyways, hopefully tomorrow will provide some answers.