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因髂腰肌脓肿导致的青少年髋关节疼痛。

Adolescent Hip Pain Due to Iliopsoas Abscess.

作者信息

Lages Pereira Rita, Nogueira Machado Sara, Macedo Liliana, Correia-Pinto Jorge, Lobo Ana

机构信息

Department of Pediatrics, Unidade Local de Saúde de Braga, Braga, PRT.

Department of Pediatrics, Unidade Local de Saúde do Alto Ave, Guimarães, PRT.

出版信息

Cureus. 2024 Oct 18;16(10):e71761. doi: 10.7759/cureus.71761. eCollection 2024 Oct.

Abstract

Hip pain in children and adolescents poses a diagnostic challenge due to various underlying causes, ranging from benign to severe conditions. Presented here is the case of an otherwise healthy 14-year-old boy who arrived at the emergency department with a two-day history of left hip pain, limping, fever, anorexia, and vomiting. Upon physical examination, tenderness was noted upon palpation of the left sacroiliac joint and with mobilization of the left lower limb. Elevated inflammatory markers raised suspicion of an osteoarticular infection. Despite initially normal imaging, subsequent MRI revealed an iliopsoas abscess, later confirmed by blood cultures positive for . A conservative management with antibiotics was selected due to the infeasibility of percutaneous or surgical drainage, leading to clinical improvement. This case highlights the efficacy of non-surgical approaches in selected situations and underscores the importance of a thorough evaluation, early suspicion of infection, appropriate imaging, and tailored antimicrobial therapy in managing hip pain in pediatric patients.

摘要

儿童和青少年的髋部疼痛因各种潜在病因(从良性到严重疾病)而带来诊断挑战。本文介绍了一名原本健康的14岁男孩的病例,他因左髋部疼痛、跛行、发热、厌食和呕吐两天而到急诊科就诊。体格检查时,触诊左骶髂关节及活动左下肢时均有压痛。炎症指标升高引发了骨关节炎感染的怀疑。尽管最初影像学检查正常,但随后的磁共振成像(MRI)显示有髂腰肌脓肿,血培养后来证实为[具体病原体]阳性。由于经皮或手术引流不可行,选择了抗生素保守治疗,临床症状得以改善。该病例突出了在特定情况下非手术方法的有效性,并强调了全面评估、早期怀疑感染、适当影像学检查以及针对儿科患者髋部疼痛进行定制抗菌治疗的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e22/11570430/802867c84094/cureus-0016-00000071761-i01.jpg

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