Abstract
Aim: To present the features and management of Pyogenic myositis in children.
Method: Two boys of four and six years old presented to our hospital within 6 months. The initial presentation suggested septic arthritis of the hip with pain, pyrexia and limited hip movements. Serum inflammatory markers were significantly raised. Hip rotation, however, was not severely reduced when examined carefully. Neither case demonstrated an effusion on ultrasound of the hip joint. The diagnosis was made on magnetic resonance imaging which produced striking images. Staphylococcus aureus was isolated from blood cultures in each case.
Results: Both children settled with antibiotic treatment alone. The bacterial strain in the second case was of a type requiring combination antibiotic therapy for effective treatment.
Conclusions: Pyogenic myositis is not a common diagnosis in previously healthy children presenting with hip pain. It is a condition that has been reported more frequently recently and which should have a higher profile since it is probably under-diagnosed. Urgent magnetic resonance imaging is recommended for atypical cases of musculoskeletal infection in children. Care must be taken to prescribe antibiotic therapy appropriate to the particular bacterial strain.
Correspondence should be addressed to: Mr J. B. Hunter, BSCOS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
