ABSTRACT
Pyomyositis is a primary bacterial infection of skeletal muscle and this is on the increase worldwide among children as well as young adults. We report herein on a case of a 29-year-old male with pyomyositis of the obturator internus. The fact that pyomyositis predominantly affects the muscles of the lower limb and it is confined to the obturator internus muscle has been poorly recognized. CT with an enhancement was an accurate imaging modality to image the obturator internus muscle and to ascertain the diagnosis for this case. The patient was managed with antibiotics and surgical intervention was not necessary. Pyomyositis of the obturator internus muscle needs to be differentiated from septic arthritis of the hip. The present study reports the clinical signs and treatments of pyomyostis and we review the relevant literature.
Subject(s)
Adult , Child , Humans , Male , Young Adult , Anti-Bacterial Agents , Arthritis, Infectious , Bacterial Infections , Hip , Lower Extremity , Muscle, Skeletal , Muscles , PyomyositisABSTRACT
Chronic pelvic pain is difficult to diagnose and usually has a poor outcome. However, if it was identified early it might have a better prognosis. We treated three patients whose trigger points in obturator internus were diagnosed as origin of myofascial pain. The first patient complained of coccygodynia with pain that radiated up his left leg when walking. The second patient had coccygeal pain that radiated to the left thigh area. The last patient was troubled with coccygeal and pelvic pain at anytime. In all of the cases MRI studies of the lumbar spine and pelvis were unrevealing. Electrodiagnostic studies were normal. The impression was that the patients had the myofascial pain syndrome, therefore injections with local anesthetics and cortisone at the myofascial pain originated in obturator internus. Although each of the patients had different symptoms, they all had a good response to treatment.