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Abnormal syndrome of iliac osteomyelitis presenting as acute appendicitis
1Division of Orthopaedics and Traumatology, University Teaching Hospital, Nnewi, Anambra State, Nigeria.
Abstract:
A case of right iliac osteomyelitis initially misdiagnosed and treated as acute appendicitis is reported. Deep-seated right lower quadrant pain persisted and a gluteal abscess appeared in the immediate post-operative period. The gluteal abscess was incised and it continued to discharge pus until appropriate diagnosis and treatment was instituted. Pain due to iliac osteomyelitis is deep-seated and may radiate to the thighs or lumbar region. Compression and distraction of the pelvis elicits pain in the affected ilium.
Insights
Iliac osteomyelitis can mimic appendicitis, leading to delayed diagnosis and treatment. Persistent pain and abscess formation highlight the importance of considering bone infection in deep-seated abdominal pain.
Area of Science:
- Orthopedics
- Infectious Diseases
- Radiology
Background:
- Osteomyelitis, a bone infection, can present with vague symptoms.
- Appendicitis is a common cause of right lower quadrant pain, often leading to surgical intervention.
Observation:
- A patient presented with right iliac osteomyelitis initially misdiagnosed as acute appendicitis.
- Post-appendectomy, the patient developed a persistent gluteal abscess with purulent discharge.
Findings:
- Deep-seated pain in the right iliac region, potentially radiating to the thigh or lumbar area, is characteristic.
- Pelvic compression and distraction maneuvers can elicit pain in osteomyelitis of the ilium.
Implications:
- This case underscores the need for a broad differential diagnosis in cases of persistent abdominal pain.
- Timely diagnosis and appropriate antibiotic therapy are crucial for managing iliac osteomyelitis and preventing complications like abscess formation.