Lab Studies:
November 11:
<br> WBC 14.9, Sed rate 4.
<br>November 16:
<br> WBC 9.3, Sed rate 33, CRP 7.0, ANA
<br> negative, RF negative, Lyme negative.
<br>November 18:
<br> WBC 8.3, Sed rate 28, CRP 2.6.
<br>December 13:
<br> WBC 5.8, Sed rate 9, CRP 0.8.
Other Studies:
November 11:
<br> X-ray and ultrasound of right hip
<br> normal. <a href="CaseStudyImages/CS1HipPainin17YearOl-92.jpg" title="Case Photo #1" data-lity><b>Case Photo #1</b></a>
<br>November 14:
<br> MRI Right hip demonstrated edema
<br> present within the right iliacus
<br> muscle and a non-specific prominence
<br> at the right piriformis muscle with
<br> edema in the superior muscle fibers.
<br> There was no fluid collection.
<br> <a href="CaseStudyImages/CS2CS1HipPainin17Yea-92.jpg" title="Case Photo #2" data-lity><b>Case Photo #2</b></a> <a href="CaseStudyImages/CS3CS2CS1HipPainin17-92.jpg" title="Case Photo #3" data-lity><b>Case Photo #3</b></a> <a href="CaseStudyImages/CS4CS3CS2CS1HipPaini-92.jpg" title="Case Photo #4" data-lity><b>Case Photo #4</b></a>
<br> <a href="CaseStudyImages/CS5CS4CS3CS2CS1HipPa-92.jpg" title="Case Photo #5" data-lity><b>Case Photo #5</b></a>
<br>November 17:
<br> CT of the pelvis demonstrated no
<br> mass lesions or abnormal fluid
<br> accumulation correlating to the
<br> region described on the MRI.
<br> <a href="CaseStudyImages/CS6CS5CS4CS3CS2CS1Hi-92.jpg" title="Case Photo #6" data-lity><b>Case Photo #6</b></a>
Consultations:
An infectious disease consult was requested. After discussion with the infectious disease team, there was concern regarding the sudden increase of inflammatory markers and their correlation with the physical exam, history and MRI. This led to the diagnosis of pyomyositis. A CT was performed to assess for fluid accumulation and to allow for proper staging and treatment.
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