title: Synchronous pyomyositis and septic hip arthritis.
abstract: The authors report a rare concomitant pyogenic infection of the iliopsoas, iliacus and external obturator muscles and of the hip joint in a 68-year-old woman. Because the patient showed the classic symptomatic triad of limping, hip pain and fever, in addition to positive hip arthrocentesis, the diagnosis of septic hip arthritis was routine, but the simultaneous pyomyositis was almost overlooked. Unusual localised heat and swelling on the front of the proximal thigh prompted a CT scan that identified remarkable muscle abscesses in addition to the septic arthritis. Surgical debridement and antibiotics resolved the infection relatively rapidly without sequelae. We noted that reaching a definitive diagnosis of such a concomitant infection requires a suspicion of the presence of pyomyositis, which can be definitively determined using advanced imaging studies.
authors.affiliation: Department of Orthopedics, College of Medicine, National Cheng Kung University, Tainan, Taiwan (ROC). ntchiu@-mail.ncku.edu.tw
authors.forename: I M
authors.initials: IM
authors.lastname: Jou
authors.forename: N T
authors.initials: NT
authors.lastname: Chiu
authors.forename: K A
authors.initials: KA
authors.lastname: Lai
authors.forename: Y C
authors.initials: YC
authors.lastname: Chuang
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents; D001170:Arthritis, Infectious / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D009220:Myositis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D013203:Staphylococcal Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013492:Suppuration; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents