Nouh, F MBBS, BSc; Visvanathan, S MBBS, BSc; Mourad, M S. MBBS; Konidaris, G MBBS; Van der Wall, H MBBS, PhD, FRACP; Bruce, W M. MBBS, FRACS, FAOrthA
A 54-year-old man with quadriplegia secondary to multiple sclerosis was admitted with an infected pressure ulcer over the right ischium. Surgical treatment included debridement and application of a vacuum dressing to the ulcer. Culture of bone scrapings from the ischium grew diphtheroids and anaerobic species. Appropriate broad-spectrum antibiotics were started. Bone scintigraphy at this time showed intense hyperemia in the right hip with increased delayed uptake in the ischium, femoral neck, and head. A leukocyte/colloid study confirmed septic arthritis and osteomyelitis of the right proximal femur. The septic arthritis/osteomyelitis was thought to be secondary to a soft-tissue communication between the ischial ulcer and the right hip. This was confirmed by subsequent surgery.
Clinical Nuclear Medicine. 29(9):552-553, September 2004.