Jou I M, Chiu N T, Lai K A, Chuang Y C
Department of Orthopedics, College of Medicine, National Cheng Kung University, Tainan, Taiwan (ROC).
Clin Rheumatol. 2000;19(5):385-8. doi: 10.1007/pl00011176.
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.
作者报告了一例68岁女性罕见的髂腰肌、髂肌和闭孔外肌以及髋关节同时发生的化脓性感染。由于患者除髋关节穿刺阳性外，还表现出跛行、髋关节疼痛和发热这一典型症状三联征，因此化脓性髋关节炎的诊断很常规，但同时存在的脓性肌炎几乎被忽视。大腿近端前部异常的局部发热和肿胀促使进行了CT扫描，结果除发现化脓性关节炎外，还发现了明显的肌肉脓肿。手术清创和使用抗生素使感染相对迅速地得到解决，且无后遗症。我们注意到，要对这种合并感染做出明确诊断，需要怀疑存在脓性肌炎，而这可以通过先进的影像学检查来明确确定。
