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Image challenge
Fluids under the skin, can you feel them?
  1. Tsae-Ni Lee1,
  2. Cho-Han Chiang2,
  3. Sung-Chuan Chao3
  1. 1 Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
  2. 2 Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
  3. 3 Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
  1. Correspondence to Sung-Chuan Chao, Department of Surgery, National Taiwan University Hospital, Taipei 100, Taiwan; truethkimo{at}yahoo.com.tw

http://dx.doi.org/10.1136/emermed-2020-210403

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    Clinical introduction

    A 30-year-old woman with no underlying disease presented with severe tenderness and swelling at the right thigh. She described a sensation of having a ‘water balloon’ under the skin. One week ago, she fell down from a motorcycle and noted clean laceration wounds with ecchymoses and swelling at the right thigh. On physical examination, there was a well-defined and fluctuant lesion around the right thigh. The skin was intact without local heat. The hip and knee joints exhibited full range of motion. Plain radiograph of the right thigh and hip did not show any bony injury. A soft tissue echo was ordered (figure 1).

    Figure 1

    Sonography of the …

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    Footnotes

    • Handling editor Ellen J Weber

    • Contributors T-NL wrote the manuscript and prepared the images. C-HC revised the manuscript and prepared the images. S-CC obtained patient consent and wrote the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.

    • Provenance and peer review Not commissioned; internally peer reviewed.