International Journal of Case Reports and Images - IJCRI - Case Reports, Case Series, Case in Images, Clinical Images

   
Case Report
 
Case report of a 13-year-old boy with an obturator internus abscess and a need for re-imaging in this condition
Janka Fazekas1, Bence Fazekas2, Balazs Fazekas3
1MBBS BSc, Northwick Park Hospital Orthopaedics Foundation Year 2 Doctor.
22MBBS BSc, University of Heidelberg, Heidelberg.
3MB BChir MA (Cantab), University of Cambridge.

doi:10.5348/ijcri-201605-CR-10592

Address correspondence to:
Janka Fazekas
Northwick Park Hospital Orthopaedics Foundation Year 2 Doctor

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How to cite this article
Fazekas J, Fazekas B, Fazekas B. Case report of a 13-year-old boy with an obturator internus abscess and a need for re-imaging in this condition. Int J Case Rep Images 2016;7(1):25–29.


Abstract
Introduction: Obturator internus pyomyositis is a rare entity, which is becoming more common in temperate regions including the United Kingdom. Typically, it presents with a triad of hip pain, fever and an inability to weight-bear on the affected side mimicking other hip pathologies such as septic arthritis. Conclusive diagnosis relies on imaging modalities such as computed tomography (CT) scan and magnetic resonance imaging (MRI) scan. Since the first described case in literature in 1992, it has been?common practice to treat the condition with intravenous antibiotics and incision and drainage if required, however, the most appropriate follow-up of this condition post-treatment has not been clearly defined. In particular, the role of post-treatment imaging?to monitor the resolution of the abscess is not yet known.
Case Report: We present a case of a 13-year-old boy with an obturator internus abscess, whose diagnosis proved to be challenging due to an initial negative hip radiograph and ultrasound. Magnetic resonance imaging (MRI) played a key role in reaching the correct diagnosis. Follow-up imaging using MRI scan proved to be essential in the successful management of this case.
Conclusion: Our case report demonstrates the importance of post-treatment imaging and suggests that this may be a suitable method to ensure resolution of the abscess and to recognise known complications such as osteomyelitis.

Keywords: Obturator internus pyomyositis, Osteomyelitis, Post-treatment imaging, Hip pain


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Author Contributions
Janka Fazekas – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Bence Fazekas – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Balazs Fazekas – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Janka Fazekas et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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