Primary obturator pyomyositis: a diagnostic challenge

Pyomyositis of the obturator muscles is a rare condition, characterised by pain in the hip and features of systemic infection. It may follow minor trauma to the hip, sometimes in the presence of an apparently innocuous infective source. All previously reported cases have been diagnosed conclusively on the initial CT or MR scan. We present a case of obturator pyomyositis in a 21-year-old football player in which the first MR scan was misleading. A radiolabelled, white blood cell scan was also negative and the resultant delay in diagnosis proved dangerous. The crucial importance of careful and repeated clinical examination is emphasised.