Hip Pain In 17 Year Old Football Player - Page #3

Lab Studies:
November 11:
WBC 14.9, Sed rate 4.
November 16:
WBC 9.3, Sed rate 33, CRP 7.0, ANA
negative, RF negative, Lyme negative.
November 18:
WBC 8.3, Sed rate 28, CRP 2.6.
December 13:
WBC 5.8, Sed rate 9, CRP 0.8.

Other Studies:
November 11:
X-ray and ultrasound of right hip
normal. Case Photo #1
November 14:
MRI Right hip demonstrated edema
present within the right iliacus
muscle and a non-specific prominence
at the right piriformis muscle with
edema in the superior muscle fibers.
There was no fluid collection.
Case Photo #2 Case Photo #3 Case Photo #4
Case Photo #5
November 17:
CT of the pelvis demonstrated no
mass lesions or abnormal fluid
accumulation correlating to the
region described on the MRI.
Case Photo #6

An infectious disease consult was requested. After discussion with the infectious disease team, there was concern regarding the sudden increase of inflammatory markers and their correlation with the physical exam, history and MRI. This led to the diagnosis of pyomyositis. A CT was performed to assess for fluid accumulation and to allow for proper staging and treatment.

Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.

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