Department of Orthopaedics, Singapore General Hospital, Singapore.
Department of Orthopaedics, Changi General Hospital, Singapore.
JBJS Case Connect. 2020 Oct 16;10(4):e20.00251. doi: 10.2106/JBJS.CC.20.00251.
The authors report a case of piriformis pyomyositis in a teenage female patient with fever and left hip pain. Her pain migrated to the knee with concurrent near resolution of hip pain. Imaging revealed an abscess in the left piriformis with pus tracking along the sciatic nerve sheath. This was complicated by internal iliac vein thrombosis and an embolus to the lung. Open drainage was performed, followed by outpatient intravenous cloxacillin and oral warfarin, with complete resolution of symptoms.
Piriformis pyomyositis is a rare condition with varying presentations. The threshold for suspicion should be low even in healthy young individuals.
作者报告了一例青少年女性患者的梨状肌肌炎病例,该患者有发热和左髋部疼痛。她的疼痛转移到膝盖,同时髋关节疼痛几乎缓解。影像学显示左侧梨状肌脓肿,脓液沿坐骨神经鞘追踪。这与髂内静脉血栓形成和肺栓塞有关。进行了切开引流,随后门诊静脉注射氯唑西林和口服华法林,症状完全缓解。
梨状肌肌炎是一种罕见的疾病,临床表现各异。即使是健康的年轻人,也应该降低对该病的怀疑阈值。