Synchronous pyomyositis and septic hip arthritis

The authors report a rare concomitant pyogenic infection of the iliopsoas, iliacus and external obturator muscles and of the hip joint in a 68-year-ol d woman. Because the patient showed the classic symptomatic triad of limpin g, hip pain and fever, in addition to positive hip arthrocentesis, the diag nosis of septic hip arthritis was routine, but the simultaneous pyomyositis was almost overlooked. Unusual localised heat and swelling on the front of the proximal thigh prompted a CT scan that identified remarkable muscle ab scesses in addition to the septic arthritis. Surgical debridement and antib iotics resolved the infection relatively rapidly without sequelae. We noted that reaching a definitive diagnosis of such a concomitant infection requi res a suspicion of the presence of pyomyositis, which can be definitively d etermined using advanced imaging studies.