 Following a discussion of the procedure with the patient, including its risks, benefits, alternatives and steps to prevent infection, informed written consent was obtained and documented in the patient's chart. The time-out form was completed to confirm patient identity and side/type of procedure. The patient was prepped and draped in the usual aseptic fashion. Local anesthesia over the target area was obtained by 1% lidocaine. Sonography revealed an approximately 5 cm heterogeneously hypoechoic collection in the forefoot corresponding to the collection seen on recent MRI. A small skin incision was made along the dorsal aspect of the forefoot. A 16-gauge needle was advanced into the collection under sonographic guidance. Despite multiple repositionings of the needle tip within the collection, no frank fluid could be aspirated. A drop of dark red/brown fluid, having the appearance of old blood products, was aspirated, placed in anaerobic culture tube, and left at the ultrasound technologist workstation to be collected by a member of the clinical service.The patient tolerated the procedure well without immediate complication. Routine post procedure instructions were communicated to the patient.ESTIMATED BLOOD LOSS: Less than 5cc. An adhesive bandage was placed on the patient’s skin.
No pus was able to be aspirated from the forefoot collection. It is possible that this collection represents a chronic hematoma.