No trauma by history. Physical exam reveals focal swelling and mild tenderness. Lab evaluation reveals mild leukocytosis.
Chest radiograph is normal.
Focal lytic area in the right distal fibula with surrounding rim of sclerosis and periosteal reaction. Focal soft tissue swelling is present adjacent to the lesion. No focal increased uptake is present in the distal right fibula. Abundant Eosinophils with no specific findings of malignancy. Dimorphic fungus suggestive of Blastomycosis.