Hip sepsis and pyomyositis

Case contributed by Jeremy Jones


Severe right hip pain with limitation of movement. Fever.

Patient Data

Age: 6 years
Gender: Male

Abnormal position of the right hip. The patient was unable/unwilling to move their leg. The x-ray doesn't really add very much to the clinical history of reluctance to move the right hip. An ultrasound is the better test.


Large right-sided hip effusion with accompanying synovial thickening.


Extensive right-sided hip sepsis. Right-sided hip effusion with widespread surrounding muscle edema involving the gluteal and adductor groups. Intramuscular collection. No marrow edema.

Case Discussion

Extensive right-sided hip infection with surrounding muscle involvement. Small collections can be aspirated under US guidance or drained surgically. Diffusion-weighted imaging is helpful in cases like these to identify pus. Long term antibiotics, often IV are required, and these patients often require a PICC.

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