Author: Hannah Imran, William Wilson / Editor: Yasmin Sultan / Codes: SLO1, SLO12, SLO4, TP10, TP7Published: 26/04/2023

A 49-year-old, previously fit and well female with no significant past medial history presented to the Emergency Department (ED) three weeks following a horse-riding injury. She had fallen off her horse and subsequently the horse stepped onto her right thigh and hamstring, resulting in an abrasion on her right thigh and hamstring that has developed into a large swelling extending into the hamstring, intermittently discharged clear fluid and gradually increased in size since the injury.

Local examination revealed, a large, soft cystic, fluid-filled fluctuant swelling on the lateral aspect of her right thigh extending into the hamstring with an overlying opening in the skin and some superficial necrosis. Additionally, the overlying skin has moderate bruising which extends a short distance distally from the swelling.

There was complete and pain-free range of motion of the affected side hip and knee. There were no neurovascular deficits.  

Routine blood investigations including FBC, CRP were normal and relevant X-rays showed no signs of fracture or osteomyelitis.

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