2000 Volume 49 Issue 4 Pages 1015-1020
We report two cases of pyogenic coxitis following pyogenic spondylitis. One case was a sixty-five-year old male treated for diabetes mellitus over a long period time, and the other case was a sixty-six-year-old male suffering from a subarachnoid hemorrhage and gastric cancer. They were confirmed to be immnocompromised hosts from their previous history of pyogenic spondylitis and iliopsoas abscess was seen in MR-imaging and CT. After treatment, pyogenic coxitis also occurred. The hip destruction of the first case continued since then, and the shape of the destruction was similar to a protrusio acetabuli seen in rheumatoid hips at the end. We therefore performed an operation using Bipolar hip arthroplasty with bone grafting. That of the second case was not progressive, so we chose a conservative treatment using only antibiotics.
We believe that the direct route through the iliopsoas from the spine to the hip joint is the route of infection.
