Physical signs in pyomyositis presenting as a painful hip in children: a case report and review of the literature.

The incidence of pyomyositis is on the increase worldwide among children and adults. When it involves muscles about the hip it needs to be differentiated from septic arthritis and transient synovitis among other diseases. Lack of awareness of the condition frequently leads to delay in correct diagnosis. We present one case of pyomyositis of the gluteus maximus and another rarer case of obturator internus pyomyositis that posed difficulties in initial diagnosis. While magnetic resonance imaging remains the imaging method of choice, we highlight important physical signs in the examination of patients presenting with a painful hip, which should raise suspicion of pyomyositis.