### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
hi sir .i m 29 years old.i have problem in my ankel.now white pus comes out from a small hole in my ankel.sometime swelling is there.some time nothing is there.no hole no pus.but after 10 days hole becomes and pus comes out.sir i have gone to many doctor but nobody came yo know about this desease.one time i have got small opperated.9 month it was ok but again same problem.plz give me suggession wht should i do

### output:

Hi, I have gone through your query and I can understand your concerns. If I were your treating physician, Based on your description I would come up with following possibilities.1- Osteomyelitis, The first and most probable differential diagnosis would be osteomyelitis.It's a kind of chronic infection of the bone. Your symptoms (pus and discharging sinuses)perfectly fits for osteomyelitis. We have to do an X-ray and biopsy to confirm the diagnosis.2-Actinomycosis-Its kind of fungal/bacterial infection. Less likely differential, multiple investigations are needed to confirm the diagnosis.3-There are other conditions also present with similar symptoms including some bone tumors, But those are rarest among the differentials and no need to worry that much. I suggest you to consult an orthopedic for detailed evaluation and proper treatment. You may require an X-ray or MRI scan for evaluation. You have to do a biopsy to confirm diagnosis. If the diagnosis of osteomyelitis is confirmed you require long course of IV antibiotics and surgical debridement. I hope this helps. Please feel free to contact us if you have any further queries. Regards. Chat Doctor. 