title: Ewing's sarcoma of the pelvis: an unusual, but not to be missed, cause of an irritable hip.
abstract: A 15-year-old girl presented with a 2-month history of non-specific right hip pain associated with pain in the back, right flank and foot. Her symptoms deteriorated, interfering with weight-bearing. Following admission, she was found to be febrile with a flexion deformity of her right-hip, and tenderness over the iliac crest and posterior pelvis. A markedly elevated C reactive protein and erythrocyte sedimentation rate, with an ultrasound-proven scan effusion within the right hip were all suggestive of septic arthritis. However, full blood count demonstrated a significant anaemia, which together with the tenderness around the pelvis was not in keeping with this diagnosis. Surgical washout was therefore delayed to obtain a MRI scan of the pelvis. The scan revealed a 5×5×3 cm necrotic soft tissue mass within the gluteal muscles, arising from the right ilium, which biopsy confirmed to be a Ewing's sarcoma.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Norfolk and Norwich University Hospital, Norwich, UK Department of Surgery, James Paget University Hospital, Gorleston-on-Sea, UK.
authors.forename: Partha
authors.initials: P
authors.lastname: Ray
authors.affiliation: Norwich Medical School, University of East Anglia, Norwich, UK.
authors.forename: Julekha
authors.initials: J
authors.lastname: Girach
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Norfolk and Norwich University Hospital, Norwich, UK.
authors.forename: Anish Pradip
authors.initials: AP
authors.lastname: Sanghrajka
mesh_terms: D000293:Adolescent; D001706:Biopsy; D002081:Buttocks / Q000473:pathology; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D007085:Ilium / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D010146:Pain / Q000175:diagnosis* / Q000209:etiology; D010388:Pelvis / Q000473:pathology; D012512:Sarcoma, Ewing / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D016474:Weight-Bearing / Q000502:physiology