Yanagita Yasutaka, Shimada Ryo, Noda Kazutaka, Ikusaka Masatomi
General Medicine, Chiba University Hospital, Chiba, JPN.
Cureus. 2023 Feb 22;15(2):e35329. doi: 10.7759/cureus.35329. eCollection 2023 Feb.
We describe a case of pubic osteomyelitis in a 17-year-old Japanese male. The patient presented with acute left groin pain and left lower quadrant pain. He was evaluated at another hospital where pelvic X-ray/computed tomography was normal, and laboratory testing revealed only high C-reactive protein. Pelvic magnetic resonance imaging (MRI) on day three showed inflammation of the pubic attachment of the rectus abdominis muscle. Furthermore, a pelvic MRI performed 10 days after onset revealed a high signal on T2 short-TI inversion recovery in the left pubic bone, which was not found in the previous MRI, leading to a diagnosis of left pubic osteomyelitis. Symptoms improved rapidly after antibiotic therapy, and treatment was completed after six weeks. When a young athlete presents with fever and acute inguinal pain, osteomyelitis of the pubic bone should be considered as a differential diagnosis. This case report emphasizes the importance of taking a sports history during the interview and performing a repeat MRI for the early diagnosis of osteomyelitis of the pubic bone.
我们报告一例17岁日本男性的耻骨骨髓炎病例。患者表现为急性左腹股沟疼痛和左下腹疼痛。他在另一家医院接受评估，骨盆X线/计算机断层扫描结果正常，实验室检查仅显示C反应蛋白升高。发病第三天的骨盆磁共振成像（MRI）显示腹直肌耻骨附着处有炎症。此外，发病10天后进行的骨盆MRI显示左侧耻骨在T2短TI反转恢复序列上有高信号，这在之前的MRI中未发现，从而诊断为左侧耻骨骨髓炎。抗生素治疗后症状迅速改善，六周后完成治疗。当年轻运动员出现发热和急性腹股沟疼痛时，应考虑耻骨骨髓炎作为鉴别诊断。本病例报告强调了在问诊时了解运动史以及重复进行MRI检查对于耻骨骨髓炎早期诊断的重要性。
