Pyomyositis of the iliacus muscle in a child

Thomas, Simon; Tytherleigh-Strong, Graham; Dodds, R

doi:10.1302/0301-620x.83b4.0830619c

Cited by 7 publications

(5 citation statements)

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“…Ultrasound and CT scan can be used as ancillary tools in the image-guided percutaneous drainage of purulent material [33]. MRI is the imaging method of choice in the pelvis, since it does not emit ionizing radiation, allows visualization on several planes, and reveals diffuse inflammation in early stages of the disease [22, 34], and it also enables the evaluation of other processes, such as hip joint effusion suggestive of septic arthritis [35, 36]. MRI is preferable because it allows the evaluation of multiple processes, such as joint effusion suggestive of septic arthritis.…”

Section: Discussionmentioning

confidence: 99%

Primary obturator-muscle pyomyositis in immunocompetent children

García-Mata

Hidalgo-Ovejero

Esparza-Estaun

2012

Journal of Children's Orthopaedics

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Purpose Primary pyomyositis in immunocompetent children in non-tropical regions (countries with temperate climates) is very uncommon. It is rarely found in the intrapelvic muscles, and even more rarely in the obturator muscles. We try to draw attention to the potential occurrence in these conditions. Methods Five new cases of primary obturator-muscle pyomyositis in immunocompetent children aged between 6 and 11 years in a temperate climate are presented. They present with symptoms as follows: fever, pain (thigh, abdominal, inguinal, and/or hip pain), and limp. Three of them had no hip movement limitation. All of them had tenderness in the perineum zone. Results Laboratory tests may reveal high erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) counts, but depend on the length of diagnostic delay. The evolution time oscillated from 1 to 5 days. Fever and limp disappearance depends on the evolution time previous to the onset of the antibiotics administration. In 4 out of 5 patients, Staphylococcus aureus was present in the blood cultures. In all cases of obturator-muscle pyomyositis, diagnosis was confirmed using computed tomography (CT) scan (one) and/or magnetic resonance imaging (MRI) (four). Conclusions Obturator-muscle pyomyositis is aimed at emphasizing the diagnostic difficulties associated with the condition, due to its deep location and to the fact that the disease presents with multiple manifestations that may initially cause confusion, since they mimic other conditions occurring in the abdomen, hip (septic arthritis, osteomyelitis), spine, etc. The diagnosis is only confirmed using CT scan and/or MRI. In the five patients with antibiotics treatment, the condition resolves without sequelae, even at long-term follow-up.

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Section: Discussionmentioning

confidence: 99%

Primary obturator-muscle pyomyositis in immunocompetent children

García-Mata

Hidalgo-Ovejero

Esparza-Estaun

2012

Journal of Children's Orthopaedics

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“…Su localización más frecuente es el músculo cuadriceps (26,3%). También puede afectar al psoas-ilíaco (14%) 13 , e incluso se han publicado casos en los músculos adductores 14 , obturador internus 15 and externus 15,16 , erector spinae 17 , gluteus maximu 15 y otras localizaciones.…”

Section: Introductionunclassified

Piomiositis primaria del músculo psoas en clima templado: Revisión a propósito de dos casos en niños seguidos a largo plazo

García-Mata

Hidalgo

Esparza³

2006

Anales Sis San Navarra

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They were successfully treated by isolated antibiotherapy in one case and surgical drainage in the other. Healing was achieved in each case without relapse or sequels in a long-term revision. We carry out a global revision of this rare infection, emphasising the difficulty of its clinical diagnosis and the different treatment modalities and the proper indication. We suggest an algorithm as a clinical guide for its clinical-therapeutic management.

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“…MRI is the preferable diagnostic tool after negative ultrasound and/or bone scan for many authors [6, 8, 10, 12, 18, 19]. MRI is ideal for evaluating soft tissue details and making early diagnosis, for distinguishing coexisting arthritis and/or osteomyelitis in T2-weighted signal, for differentiating between invasive or purulent stages with gadolinium, and delineating between involved muscle and edema [5, 7, 13, 17, 20, 24]. Briefly, MRI is a valuable diagnostic study for evaluating several different septic entities around the hip and allowing a final diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…The typical age of presentation ranges between 5 and 9 years [3–5, 13, 20], and it is more frequent in males. Pelvic muscles, thighs, and calves are common locations [7], but multifocal location has been published in up to 43% of cases [2].…”

Section: Discussionmentioning

confidence: 99%

Imaging on pelvic pyomyositis in children related to pathogenesis

Morán

Durán

Albiñana

2009

Journal of Children's Orthopaedics

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Purpose Pelvic pyomyositis in children is a rare infectious condition, although it is increasingly reported in temperate climates. Often considered a primary disease, new diagnostic methods are able to identify additional foci of infection. The purpose of this study is to review our patients and to analyze the imaging studies to determine its pathogenesis. Methods A retrospective study of the clinical charts and imaging records of 11 patients was made, noting the number and location of muscles involved, as well as bone and joint involvement. Results Besides the classical form of pelvic pyomyositis, i.e., iliopsoas pyomyositis, other muscular groups were frequently affected, often with multiple involvement. Bone involvement is also frequent. Magnetic resonance imaging (MRI) gives the most useful information. Conclusion MRI is the diagnostic procedure of choice for diagnosing pelvic pyomyositis in children. It may also have an elucidating role in the debated pathogenesis of this condition. In most of the cases, pelvic pyomyositis in children could be secondary.

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Pyomyositis of the iliacus muscle in a child

Cited by 7 publications

References 0 publications

Primary obturator-muscle pyomyositis in immunocompetent children

Primary obturator-muscle pyomyositis in immunocompetent children

Piomiositis primaria del músculo psoas en clima templado: Revisión a propósito de dos casos en niños seguidos a largo plazo

Imaging on pelvic pyomyositis in children related to pathogenesis

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