Leong Van Jet, Abbas Azlina A, Ayob Khairul A, Loh Kwong Weng, Rahman Nazarina A, Selvaratnam Veenesh
National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL) Department of Orthopaedic Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MYS.
Department of Pathology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MYS.
Cureus. 2024 Aug 26;16(8):e67798. doi: 10.7759/cureus.67798. eCollection 2024 Aug.
We present a case of a 73-year-old lady with a previous uncemented left total hip arthroplasty (THA) three years prior to her current presentation. She presented with an enlarging 'granulomatous'-looking swelling at the distal aspect of her THA scar for three months that was associated with shooting pain from the posterior aspect of her hip radiating down to her foot. The culture and sensitivity of her hip aspirate revealed the growth of . She underwent revision surgery utilising a 'well-fixed' Exeter custom-made articulating spacer (CUMARS). Intra-operatively, a large encapsulated cyst containing rice bodies was discovered deep within the fascia lata. A complete excision of this cyst was performed. Post-operatively, the patient was treated with two weeks of IV antibiotics and ten weeks of oral antibiotics. Histopathological examination confirmed the presence of rice bodies, with no malignancy seen. We aim to highlight the possibility of rice body cyst formation in the setting of a periprosthetic joint infection (PJI) around a THA and the importance of early treatment in such cases. This is the first published report of a rice body cyst formation in an infected THA.
我们报告一例73岁女性病例,在本次就诊前三年曾接受左侧非骨水泥型全髋关节置换术(THA)。她因THA瘢痕远端出现一个三个月来不断增大的“肉芽肿样”肿胀前来就诊,该肿胀伴有从臀部后方放射至足部的刺痛。对其髋关节穿刺液进行培养及药敏试验,结果显示……生长。她接受了翻修手术,使用了“固定良好”的埃克塞特定制关节融合器(CUMARS)。术中,在阔筋膜深层发现一个大的包膜囊肿,内有米粒体。对该囊肿进行了完整切除。术后,患者接受了两周的静脉抗生素治疗和十周的口服抗生素治疗。组织病理学检查证实存在米粒体,未见恶性病变。我们旨在强调在THA周围假体周围关节感染(PJI)情况下形成米粒体囊肿的可能性以及此类病例早期治疗的重要性。这是关于感染性THA中米粒体囊肿形成的首篇发表报告。