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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 at four months after delivery. Coronal T2-weighted image demonstrates slightly decreased marrow signal in the left hip (arrow) and a decrease in joint effusion and adjacent soft tissue edema of the right hip (arrow head) (A) but a slight aggravation of the depressed lesion on the anterosuperior aspect of the right femoral head (arrow) (B).
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Figure 3: Magnetic resonance images at four months after delivery. Coronal T2-weighted image demonstrates slightly decreased marrow signal in the left hip (arrow) and a decrease in joint effusion and adjacent soft tissue edema of the right hip (arrow head) (A) but a slight aggravation of the depressed lesion on the anterosuperior aspect of the right femoral head (arrow) (B).

Mentions: We stopped the antibiotic therapy and started conservative treatment. After 2 weeks of medical care, her acute symptoms, such as pain and heating sensation were improved and she started receiving rehabilitation treatment. However, limitation of motion (LOM) and pain in bilateral hip joints persisted although rehabilitative therapy was continued for 3 months. MR images of bilateral hip joints were re-obtained and they showed slightly decreased marrow signal in the left hip, sacroiliac joint, and symphysis pubis. They also showed a decrease in joint effusion and adjacent soft tissue edema of the right hip, but a slight aggravation of the depressed lesion on the anterosuperior aspect of the femoral head. Infection with low virulence organism, spondyloarthropathy or postpartum rheumatoid arthritis, was suspected (Fig. 3). We conducted US-guided gun biopsy of synovium in the left hip joint and there was no evidence of inflammation. Her laboratory findings were normal and she had a pain score of 3 on a 0-10 point visual analogue scale. She was discharged and she continued physical therapy at a local hospital.


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 at four months after delivery. Coronal T2-weighted image demonstrates slightly decreased marrow signal in the left hip (arrow) and a decrease in joint effusion and adjacent soft tissue edema of the right hip (arrow head) (A) but a slight aggravation of the depressed lesion on the anterosuperior aspect of the right femoral head (arrow) (B).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Magnetic resonance images at four months after delivery. Coronal T2-weighted image demonstrates slightly decreased marrow signal in the left hip (arrow) and a decrease in joint effusion and adjacent soft tissue edema of the right hip (arrow head) (A) but a slight aggravation of the depressed lesion on the anterosuperior aspect of the right femoral head (arrow) (B).
Mentions: We stopped the antibiotic therapy and started conservative treatment. After 2 weeks of medical care, her acute symptoms, such as pain and heating sensation were improved and she started receiving rehabilitation treatment. However, limitation of motion (LOM) and pain in bilateral hip joints persisted although rehabilitative therapy was continued for 3 months. MR images of bilateral hip joints were re-obtained and they showed slightly decreased marrow signal in the left hip, sacroiliac joint, and symphysis pubis. They also showed a decrease in joint effusion and adjacent soft tissue edema of the right hip, but a slight aggravation of the depressed lesion on the anterosuperior aspect of the femoral head. Infection with low virulence organism, spondyloarthropathy or postpartum rheumatoid arthritis, was suspected (Fig. 3). We conducted US-guided gun biopsy of synovium in the left hip joint and there was no evidence of inflammation. Her laboratory findings were normal and she had a pain score of 3 on a 0-10 point visual analogue scale. She was discharged and she continued physical therapy at a local hospital.

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