J Korean Hip Soc.  2010 Dec;22(4):319-322. 10.5371/jkhs.2010.22.4.319.

Obturator Internus Pyomyositis: A Case Report

• Kim DY
• Park SJ
• Chang JD
• Nam JS
• Lee SS

• KMID: 1461188
• DOI: http://doi.org/10.5371/jkhs.2010.22.4.319

Abstract

Pyomyositis is a primary bacterial infection of skeletal muscle and this is on the increase worldwide among children as well as young adults. We report herein on a case of a 29-year-old male with pyomyositis of the obturator internus. The fact that pyomyositis predominantly affects the muscles of the lower limb and it is confined to the obturator internus muscle has been poorly recognized. CT with an enhancement was an accurate imaging modality to image the obturator internus muscle and to ascertain the diagnosis for this case. The patient was managed with antibiotics and surgical intervention was not necessary. Pyomyositis of the obturator internus muscle needs to be differentiated from septic arthritis of the hip. The present study reports the clinical signs and treatments of pyomyostis and we review the relevant literature.

Keyword

Obturator internus muscle; Pyomyositis

MeSH Terms

Adult
Anti-Bacterial Agents
Arthritis, Infectious
Bacterial Infections
Child
Hip
Humans
Lower Extremity
Male
Muscle, Skeletal
Muscles
Pyomyositis
Young Adult
Anti-Bacterial Agents

Figure

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  Fig. 1 (A) Axial computed tomography with enhancement show ill-defined hypodense lesion in obturator internus muscle (arrow). (B) Diminished swelling and calcific change in obturator internus muscle (arrow) on follow-up computed tomography with enhancement.

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  Fig. 2 Coronal fat-suppressed (STIR) image shows mild thickening with rim enhancing lesions of left obturator internus muscle (arrows).

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  Fig. 3 After regime displaced with 3rd generation cephalosporin (ceftriaxon) and metronidazole (arrow), (A) fever went down gradually and (B) inflammatory markers returned to normal.

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