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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sonographic applications to osteomyelitis, myositis ossificans, tropic pyomyositis, child abuse, synovitis, and slipped capital femoral epiphyses; MR imaging (including gadolinium-enhanced MR scans) in osteomyelitis, the normal and abnormal physis, physeal bars, normal marrow, Gaucher disease, cancer, dysplasia epiphysealis hemimelica, myositis, tenosynovitis, arthritis, and clubfoot; nuclear imaging in osteomyelitis, tibia valga, limp, and unexplained lower extremity pain; and CT in osteomyelitis, are reviewed. Routine long-bone radiography for patients with congenital syphilis is not recommended. Tibia valga after fracture has not been fully explained; tibia valga also follows treatment of renal failure. Nonsupracondylar humerus fractures in infants and femoral shaft fractures in the first year of life may suggest child abuse.
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PMID:Imaging of the skeleton and soft tissues in children. 129 52

We describe a man in whom pyomyositis developed in a temperate climate. Three facts make this case unique. First the pyomyositis developed in someone with underlying dermatomyositis, this being the second reported case to our knowledge. Second, the organism involved was a Streptococcus and not a Staphylococcus as in most cases described, and the course of the disease was acute and not subacute as is usually reported. Finally, contrary to most described cases, surgical drainage was not necessary, probably because of the early diagnosis. Pyomyositis should be considered a possible cause of localized pain in patients with underlying inflammatory muscle disease.
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PMID:Streptococcus pyomyositis occurring in a patient with dermatomyositis in a country with temperate climate. 140 72

Although rare, tropical pyomyositis can result from staphylococcal bacteremia and should be considered in the different diagnosis of fever associated with extremity pain. The diagnosis is readily made with a CT scan. Treatment is primarily medical with surgery reserved for refractory abscesses.
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PMID:Tropical pyomyositis. 155 7

We describe two cases of pyomyositis in two patients with acquired immunodeficiency syndrome. Neither of the two cases had previous history of predisposing factors and both patients began with fever and pain at the site of the lesions. Aspiration by punction was required in addition to the antimicrobial therapy.
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PMID:[Pyomyositis in AIDS]. 215 82

Two children, aged 6 and 8 years, were admitted to the hospital because of fever, pain, and tenderness over the muscular masses of the thigh and calf, respectively. The presumptive diagnosis of pyomyositis was confirmed by ultrasound studies. Antibiotic treatment was administered in both cases while one child also required surgical drainage of the muscular suppuration. Complete recovery was achieved in both cases. Performance of ultrasound studies is indicated whenever pyomyositis is suspected.
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PMID:Non-invasive diagnosis of pyomyositis. 328 85

Ten cases of pyomyositis of the iliacus muscle are described in otherwise healthy young Samoans. The correct diagnosis was frequently delayed. Staphylococcus aureus was the most common pathogen isolated from drained abscesses. Preference for hip flexion was seen in six patients, and localized pain or induration at the anterior superior iliac spine were found in seven patients. These clues may help expedite a correct diagnosis.
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PMID:Tropical pyomyositis of the iliacus muscle in American Samoa. 688 29

Obturator internal muscle (OIM) abscess or pyomyositis, a poorly recognized intrapelvic infection, is characterized by limping, pain in the hip with limited movement, and the sciatic type of radiating leg pain. With the use of advanced diagnostic tools such as computed tomography (CT), magnetic resonance imaging, and radionuclide scans, several cases of OIM abscess have been diagnosed; these cases have recently been reported in the English-language literature. Staphylococcus aureus is the predominant organism isolated from OIM abscesses. Gonococcal abscess involving the OIM has not been reported. We describe a case of gonococcal OIM abscess in an adolescent female whose condition was successfully diagnosed and managed with the use of CT-guided needle aspiration and antibiotic therapy. We review the English-language literature regarding the use of newly developed tools in the diagnosis of OIM abscess.
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PMID:Gonococcal abscess of the obturator internal muscle: use of new diagnostic tools may eliminate the need for surgical intervention. 762 28

There is an increasing population of immunocompromised patients with HIV, IV drug abuse, organ transplantation, and long-term steroid treatment developing spinal infections. Delayed diagnosis because of blunted host immune response and lack of outward signs and symptoms places the treating physician at a disadvantage in the treatment of this type of disease, which presents at a later stage of development. Immunocompromised patients are infected by a different group of pathogens than their healthier cohorts (e.g., Pseudomonas, gram-negative bacteria and fungal infections) because their host defenses are diminished. Osteomyelitis with or with out pyomyositis and epidural abscess may occur. The overriding symptom is back pain. Radiculopathy, myelopathy, and sensory loss may accompany local pain and tenderness. Plain film radiography, CT scan, MR image, and bone scan is invaluable in the diagnosis of these infections. The cornerstone of treatment is identification of the responsible pathogen, appropriate medical therapy, immobilization of the affected segment of the spine, and physical therapy to combat physical deconditioning. Psoas abscesses may require surgical debridement if they cannot be adequately drained by CT-guided percutaneous catheterization. Epidural abscesses with neurologic compromise require surgical drainage. Impingement of the spinal cord or cauda equina by collapsed osteomyelitic vertebral bodies requires surgical debridement by anterior vertebrectomy, with an autologous tricortical iliac crest strut and immobilization of the spine using external bracing or posterior instrumentation as dictated by the disease.
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PMID:Spinal infections in the immunocompromised host. 853 51

The incidence of invasive group A streptococcal (GAS) infections in primary varicella appears to be increasing. GAS infections complicating varicella range from cellulitis, abscess, and septic arthritis to life-threatening necrotizing fasciitis and pyomyositis in association with GAS toxic shock syndrome (TSS). Four patients admitted in 1 year to the Children's Hospital and Medical Center in Seattle, whose care included evaluation and treatment by the Orthopaedic service, are presented to illustrate this spectrum. Three had a delay in diagnosis, including discharge from previous emergency department visits. One patient with polyarticular septic arthritis was treated with diagnostic aspiration and intravenous antibiotics. The remainder required urgent surgical debridement for treatment of deep infection. Patients with necrotizing fasciitis or pyomyositis had life-threatening complications of TSS, including hypotension, adult respiratory distress syndrome (ARDS), coagulopathy, and acute renal failure. These patients required aggressive fluid resuscitation and prolonged intensive care unit support. Diagnostic imaging studies were obtained in one patient with necrotizing pyomyositis but may have served only to delay definitive treatment. Recognition of the potential for secondary GAS infections and a high index of suspicion for the presence of necrotizing soft-tissue infection are essential in the evaluation of any child with fever and localized extremity pain with varicella.
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PMID:Orthopaedic manifestations of invasive group A streptococcal infections complicating primary varicella. 878 12

Pyomyositis is an uncommon cause of musculoskeletal pain in children and adolescents living in temperate climates. Toxic shock syndrome is a life-threatening potential complication of pyomyositis. We report a case of acute hematogenous pyomyositis, complicated by toxic shock syndrome, and review the pertinent literature.
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PMID:Pyomyositis with toxic shock syndrome presenting as back pain and fever: a case report and literature review. 904 Aug 88


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