Subcutaneous emphysema of the leg: Could be a fatal condition

Gas in the leg is not always a gas gangrene. Abdominal infection with gas forming organisms may spread to the thigh & leg. We report a case of critically ill patient who presented to the emergency department with features suggestive of septic arthritis of the left hip. Assessment and further intervention revealed subcutaneous emphysema of the leg secondary to an infection of a previously asymptomatic staghorn calculus. X-ray of the abdomen showed a left renal stone and gas in the soft tissue planes of the left retroperitoneal space while X-ray of the left femur showed gas in the soft tissue planes of the left hip region and whole thigh with no bony or joint abnormality. Such case has not been reported in English literature before. Physicians and surgeons should be aware of this condition that could be fatal but curable by early intervention.