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Missed presentation of Crohn's disease in a patient with a fistulating thigh abscess: a case report.

Ferguson D, Suppiah A, Richards E, Wilson J, Pai D, Kar A - Cases J (2010)

Bottom Line: Musculoskeletal presentations of Crohn's disease are rare and they include psoas abscess, thigh abscesses and in extreme cases septic arthropathy.Herein, we present a 53 year old gentleman with bilateral thigh fistulae discovered to be a new diagnoses of extra-intestinal Crohn's disease It is important to consider Crohn's disease in patients that present with unusual or persistent fistulae and to consider this essential when there are atypical organisms present.

View Article: PubMed Central - HTML - PubMed

Affiliation: Scunthorpe General Hospital, Cliff Gardens Cliff Gardens, Scunthorpe, South Humberside DN15 7BH, UK. deborahferguson@doctors.org.uk.

ABSTRACT

Background: Musculoskeletal presentations of Crohn's disease are rare and they include psoas abscess, thigh abscesses and in extreme cases septic arthropathy.

Case presentation: Herein, we present a 53 year old gentleman with bilateral thigh fistulae discovered to be a new diagnoses of extra-intestinal Crohn's disease

Conclusion: It is important to consider Crohn's disease in patients that present with unusual or persistent fistulae and to consider this essential when there are atypical organisms present.

No MeSH data available.


Related in: MedlinePlus

STIR axial of the pelvis showing oedema with in the soft tissue involving the right piriformis muscle extending into the gluteal muscles on right side.
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Figure 2: STIR axial of the pelvis showing oedema with in the soft tissue involving the right piriformis muscle extending into the gluteal muscles on right side.

Mentions: A 53-year-old white British gentleman presented with a 2 month history of purulent discharge from a sinus on the right lateral thigh. He was otherwise systemically well and has no significant past medical history. On admission he was apyrexial and haemodynamically stable. Examination revealed normal right hip movement. X-ray showed soft tissue radiolucent abnormality just distal to the lesser trochanter. Inflammatory markers were raised (CRP 165, WCC 13.1 × 109/L and neutrophils10.5 × 109/L) and wound cultures grew group B Streptococci and he was commenced on flucloxacillin and benzyl penicillin. Limited-view right hip MRI showed two locules of gas in the soft tissue just outside piriformis muscle and adjacent to the right femur (Figure 1) and signal changes in the right gluteal muscles (Figure 2) and a small collection within the muscles lateral to the right hip joint with no evidence of osteomyelitis.


Missed presentation of Crohn's disease in a patient with a fistulating thigh abscess: a case report.

Ferguson D, Suppiah A, Richards E, Wilson J, Pai D, Kar A - Cases J (2010)

STIR axial of the pelvis showing oedema with in the soft tissue involving the right piriformis muscle extending into the gluteal muscles on right side.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2823715&req=5

Figure 2: STIR axial of the pelvis showing oedema with in the soft tissue involving the right piriformis muscle extending into the gluteal muscles on right side.
Mentions: A 53-year-old white British gentleman presented with a 2 month history of purulent discharge from a sinus on the right lateral thigh. He was otherwise systemically well and has no significant past medical history. On admission he was apyrexial and haemodynamically stable. Examination revealed normal right hip movement. X-ray showed soft tissue radiolucent abnormality just distal to the lesser trochanter. Inflammatory markers were raised (CRP 165, WCC 13.1 × 109/L and neutrophils10.5 × 109/L) and wound cultures grew group B Streptococci and he was commenced on flucloxacillin and benzyl penicillin. Limited-view right hip MRI showed two locules of gas in the soft tissue just outside piriformis muscle and adjacent to the right femur (Figure 1) and signal changes in the right gluteal muscles (Figure 2) and a small collection within the muscles lateral to the right hip joint with no evidence of osteomyelitis.

Bottom Line: Musculoskeletal presentations of Crohn's disease are rare and they include psoas abscess, thigh abscesses and in extreme cases septic arthropathy.Herein, we present a 53 year old gentleman with bilateral thigh fistulae discovered to be a new diagnoses of extra-intestinal Crohn's disease It is important to consider Crohn's disease in patients that present with unusual or persistent fistulae and to consider this essential when there are atypical organisms present.

View Article: PubMed Central - HTML - PubMed

Affiliation: Scunthorpe General Hospital, Cliff Gardens Cliff Gardens, Scunthorpe, South Humberside DN15 7BH, UK. deborahferguson@doctors.org.uk.

ABSTRACT

Background: Musculoskeletal presentations of Crohn's disease are rare and they include psoas abscess, thigh abscesses and in extreme cases septic arthropathy.

Case presentation: Herein, we present a 53 year old gentleman with bilateral thigh fistulae discovered to be a new diagnoses of extra-intestinal Crohn's disease

Conclusion: It is important to consider Crohn's disease in patients that present with unusual or persistent fistulae and to consider this essential when there are atypical organisms present.

No MeSH data available.


Related in: MedlinePlus