Pediatric Acetabular Osteomyelitis Treated With Hip Arthroscopy

Area of Science:

• Orthopedic Surgery
• Pediatric Infectious Disease
• Musculoskeletal Imaging

Background:

• Osteomyelitis of the acetabulum is uncommon, representing a small fraction of pelvic osteomyelitis cases.
• This report focuses on a pediatric patient with subacute acetabular osteomyelitis and secondary hip septic arthritis.

Observation:

• A 10-year-old girl presented with groin pain, elevated inflammatory markers, hip synovial thickening, and acetabular inflammation on MRI.
• Initial antibiotic treatment failed, with worsening infection and intra-articular extension observed on repeat MRI.
• Hip aspirate identified Fusobacterium, an unusual anaerobic pathogen.

Findings:

• Hip arthroscopy facilitated identification of the infection source and allowed for thorough debridement and irrigation.
• This surgical intervention was successful in controlling and eradicating the acetabular osteomyelitis and septic arthritis.
• The patient achieved full recovery of hip function and returned to normal activities.

Implications:

• Hip arthroscopy is a valuable surgical option for acetabular osteomyelitis with intra-articular extension and concurrent septic arthritis.
• Early and aggressive surgical management may be crucial for favorable outcomes in pediatric hip joint infections.
• This case highlights the importance of considering atypical pathogens in refractory bone and joint infections.