ABSTRACT
A 40-year-old man presented with right leg swelling and a cough on deep inspiration. He was an intravenous drug user who had a long history of injecting into his lower limb veins but more frequently performed ‘skin-popping’ over recent months due to difficulties with venous access. He felt that over the past few days, his right leg had been increasing in size and was painful to touch. He was now unable to weight-bear on the right leg. He denied any fevers, sweats or weight loss. His past history was significant for chronic left leg venous ulceration and hepatitis C. He drank 50 units of alcohol per week, smoked 30 cigarettes daily and used heroin and crack cocaine several times per week.
