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Osteomyelitis of Bilateral Femoral Heads After Childbirth: A Case Report.

Lee KS, Kong S, Kim J, Kim T, Choi CB, Kim YS, Lee KH - Ann Rehabil Med (2015)

Bottom Line: The patient described in this case suffered from severe hip pain after childbirth.The patient's clinical symptoms and laboratory findings improved with antibiotic therapy.However, limitation of motion of the bilateral hip joints persisted although the patient continued rehabilitative therapy for 15 months, and the patient had to undergo bilateral total hip replacement.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation Medicine, Hanyang University Medical Center, Hanyang University College of Medicine, Seoul, Korea.

ABSTRACT
Hip and pelvic pain during pregnancy or after delivery is a common problem in young females, and in most cases this problem has a self-limiting course. The patient described in this case suffered from severe hip pain after childbirth. MR imaging study was performed and it showed arthritis of bilateral hip joints and osteomyelitis of femoral heads with an abscess in the surrounding muscle. Infection, such as septic arthritis or osteomyelitis, is an extremely rare cause of peripartum joint pain. The patient's clinical symptoms and laboratory findings improved with antibiotic therapy. However, limitation of motion of the bilateral hip joints persisted although the patient continued rehabilitative therapy for 15 months, and the patient had to undergo bilateral total hip replacement. Hereby, we present a case of severe osteomyelitis and pyogenic arthritis of bilateral femoral heads and hip joints after delivery, which eventually required bilateral total hip replacement.

No MeSH data available.


Related in: MedlinePlus

Magnetic resonance images of the sacroiliac joint. Coronal enhanced T1-weighted image shows osteomyelitis of bilateral femoral heads (A), and transverse enhanced T1-weighted image showed left sacroiliitis (arrow), and a suspicious abscess in the left iliacus muscle (arrow head) (B).
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Figure 1: Magnetic resonance images of the sacroiliac joint. Coronal enhanced T1-weighted image shows osteomyelitis of bilateral femoral heads (A), and transverse enhanced T1-weighted image showed left sacroiliitis (arrow), and a suspicious abscess in the left iliacus muscle (arrow head) (B).

Mentions: A 35-year-old female gave birth to a preterm baby through a NSVD. She had no medical history other than that of one abortion because of ectopic pregnancy two years before delivery. She started complaining of pain in the bilateral hip area 12 days after delivery. High fever (38.4℃) with tenderness and heating sensation on the bilateral hip area also developed 17 days after delivery. The blood tests showed leukocytosis (14,250/mm3) and increased C-reactive protein (CRP) level of 15.2 mg/dL. The physicians decided to obtain magnetic resonance (MR) images of the sacroiliac joints. The MR images demonstrated osteomyelitis of bilateral femoral heads, left sacroiliitis, and a suspicious abscess in the left iliacus muscle (Fig. 1).


Osteomyelitis of Bilateral Femoral Heads After Childbirth: A Case Report.

Lee KS, Kong S, Kim J, Kim T, Choi CB, Kim YS, Lee KH - Ann Rehabil Med (2015)

Magnetic resonance images of the sacroiliac joint. Coronal enhanced T1-weighted image shows osteomyelitis of bilateral femoral heads (A), and transverse enhanced T1-weighted image showed left sacroiliitis (arrow), and a suspicious abscess in the left iliacus muscle (arrow head) (B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4496524&req=5

Figure 1: Magnetic resonance images of the sacroiliac joint. Coronal enhanced T1-weighted image shows osteomyelitis of bilateral femoral heads (A), and transverse enhanced T1-weighted image showed left sacroiliitis (arrow), and a suspicious abscess in the left iliacus muscle (arrow head) (B).
Mentions: A 35-year-old female gave birth to a preterm baby through a NSVD. She had no medical history other than that of one abortion because of ectopic pregnancy two years before delivery. She started complaining of pain in the bilateral hip area 12 days after delivery. High fever (38.4℃) with tenderness and heating sensation on the bilateral hip area also developed 17 days after delivery. The blood tests showed leukocytosis (14,250/mm3) and increased C-reactive protein (CRP) level of 15.2 mg/dL. The physicians decided to obtain magnetic resonance (MR) images of the sacroiliac joints. The MR images demonstrated osteomyelitis of bilateral femoral heads, left sacroiliitis, and a suspicious abscess in the left iliacus muscle (Fig. 1).

Bottom Line: The patient described in this case suffered from severe hip pain after childbirth.The patient's clinical symptoms and laboratory findings improved with antibiotic therapy.However, limitation of motion of the bilateral hip joints persisted although the patient continued rehabilitative therapy for 15 months, and the patient had to undergo bilateral total hip replacement.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation Medicine, Hanyang University Medical Center, Hanyang University College of Medicine, Seoul, Korea.

ABSTRACT
Hip and pelvic pain during pregnancy or after delivery is a common problem in young females, and in most cases this problem has a self-limiting course. The patient described in this case suffered from severe hip pain after childbirth. MR imaging study was performed and it showed arthritis of bilateral hip joints and osteomyelitis of femoral heads with an abscess in the surrounding muscle. Infection, such as septic arthritis or osteomyelitis, is an extremely rare cause of peripartum joint pain. The patient's clinical symptoms and laboratory findings improved with antibiotic therapy. However, limitation of motion of the bilateral hip joints persisted although the patient continued rehabilitative therapy for 15 months, and the patient had to undergo bilateral total hip replacement. Hereby, we present a case of severe osteomyelitis and pyogenic arthritis of bilateral femoral heads and hip joints after delivery, which eventually required bilateral total hip replacement.

No MeSH data available.


Related in: MedlinePlus