Roentgen rounds #94. Osteomyelitis of the left ilium--left iliacus muscle abscess

A left iliac osteomyelitis and left iliacus muscle abscess occurred in a patient who underwent bipolar hemiarthroplasty of the left hip six months prior for avascular necrosis of the left femoral head, secondary to sickle-cell disease. This illness followed an upper respiratory tract infection, and her physical examination was suggestive of a septic process involving the left hip. An aspirate of the hip was not confirmative for septic arthritis. The plain roentgenograms demonstrated that the prosthesis was in an acceptable position, but had limited value in the remainder of the differential diagnosis. In this case, the bone scan contributed significant information distinguishing osteomyelitis from osteonecrosis. The CT scan allowed rapid localization of an occult abscess and destructive changes in the left ilium secondary to osteomyelitis and guided surgical treatment.