Young Male With Severe Ankle Pain

A 38-year-old man presented with 4 days of severe pain and swelling to his right ankle. He regularly injected heroin and had last done so 1 week before. He had not been improving after 3 days of oral antibiotics prescribed by an outpatient clinic. On examination, the patient was afebrile but had a red, swollen ankle and severe pain with passive motion. Point-of-care ultrasonography was performed. Although no abscess or ankle effusion was identified, the tibialis anterior tendon was surrounded by a halo of fluid (Figure 1).

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