A Case of Suppurative Iliopsoitis in a 12-year-old Girl

Abstract

We report herein on the diagnosis of a case of suppurative iliopsoitis based on the early specific symptoms of a young girl's posture and gait.

A 12-year-old girl presented at our hospital with complaints of pain in her right coxa and fever for 5 days. She walked with a right limp and her right coxa was slightly crooked caused by pain. We diagnosed her illness as suppurative iliopsoitis because the inflammatory responses were high and plain CT images revealed a low absorption region around the right iliopsoas muscle coupled with a high density area around the right iliac muscle and psoas major muscle in a pelvic examination with short tau inversion recovery (STIR) MRI. Intravenous meropenem, 1 g/day divided, for 14 days soon achieved improvement. We could not identify what the causative bacterium was because the patient's blood culture was negative.

Suppurative iliopsoitis occurs commonly through hematogenic infection with Staphylococcus aureus, and severe cases require surgery. Early intervention using antibiotics affected a cure for this patient without any sequelae. It is important we should make a diagnosis suppurative iliopsoitis with the use of imaging tools and start medication immediately if we suspect this disease, based on the patient's symptoms.