Acute pyomyositis of the pelvis: The spectrum of clinical presentations and MR findings

Boaz Karmazyn, Martin B. Kleiman, Kenneth Buckwalter, Randall T. Loder, Aslam Siddiqui, Kimberly E. Applegate

Research output: Contribution to journalArticle

41 Scopus citations

Abstract

Background: Acute pelvic pyomyositis is uncommon in non-tropical areas. Objective: To summarize the clinical and MR findings in children with acute pelvic pyomyositis. Materials and methods: We retrospectively identified 20 children (mean age 9.4 years) who were evaluated by MR and diagnosed with acute pelvis pyomyositis during the time period between January 2002 and June 2005. We reviewed clinical, laboratory, and imaging findings. Results: Fifteen of the 20 children had secondary pyomyositis associated with osteomyelitis (n=13), septic hip (n=4) or sacroiliitis (n=4); all were previously healthy except for one child with leukemia. Seven of the children with secondary pyomyositis underwent bone scintigraphy; three (43%) did not show pelvic abnormalities. Staphylococcus aureus was cultured in 13 of the 15 (87%) children. Five of the 20 children had primary pyomyositis. Three had underlying disease and two others were engaged in vigorous physical activity. Bone scintigraphies (n=2) were negative. Cultures were positive for S. aureus in three of the five (60%) children. Conclusion: Septic hip should be the first diagnostic consideration in children with fever and acute hip pain. Pyomyositis should be considered if art/hrocentesis is negative or there is clinical suspicion of infection outside the hip joint. MR is the preferred imaging modality for evaluating foci of pyomyositis, muscle abscesses, and additional foci of infection within the pelvis.

Original languageEnglish (US)
Pages (from-to)338-343
Number of pages6
JournalPediatric Radiology
Volume36
Issue number4
DOIs
StatePublished - Apr 1 2006

Keywords

  • Children
  • Hip pain
  • MR
  • Pyomyositis
  • Staphylococcus aureus

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Pediatrics, Perinatology, and Child Health
  • Radiological and Ultrasound Technology

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