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Case Report
Rapid destructive osteoarthritis of the hip: Vanishing femoral head with MRI findings mimicking septic arthritis
1 Consultant, Department of Radiology, Lovisenberg Diaconal Hospital, Oslo, Norway
2 Head of Department of Radiology, Lovisenberg Diaconal Hospital, Pb 4970 Nydalen, 0440 Oslo, Norway
3 Head of Department of Orthopedic Surgery, Lovisenberg Diaconal Hospital, Pb 4970 Nydalen, 0440 Oslo, Norway
4 Consultant, Department of Radiology, Lovisenberg Diaconal Hospital, Pb 4970 Nydalen, 0440 Oslo, Norway
Address correspondence to:
Kaja Johannson Oedegaard
Department of Radiology, Lovisenberg Diaconal Hospital, Pb 4970 Nydalen, 0440 Oslo,
Norway
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Article ID: 100020Z14KO2019
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How to cite this article
Oedegaard KJ, Kvakestad R, Aamodt A, Adar M. Rapid destructive osteoarthritis of the hip: Vanishing femoral head with MRI findings mimicking septic arthritis. J Case Rep Images Orthop Rheum 2019;4:100020Z14KO2019.ABSTRACT
Introduction: Rapid destructive osteoarthritis of the hip is a rare disorder of unknown etiology characterized by rapid destruction of the hip joint. We present a case with complete destruction of the femoral head and extensive soft tissue involvement on magnetic resonance imaging (MRI) mimicking septic arthritis, but with lack of clinical evidence of infection.
Case Report: A 75-year-old woman presented with left hip pain and leg discrepancy. Imaging showed complete destruction of the left femoral head and acetabular irregularities, joint effusion, synovitis, extensive soft-tissue edema, and contrast enhancement of the gluteal musculature with an intramuscular loculament on MRI initially interpreted as possible septic arthritis with abscess formation. There were no clinical findings suggestive of infection or other destructive arthropathy. She was successfully operated with a single-stage total hip arthroplasty, and recovered without any complications.
Conclusion: The MRI appearance of rapid destructive osteoarthritis may mimic septic arthritis. The radiologist should be aware of the diagnosis and differential diagnoses of destructive arthropathy in order to avoid unnecessary delay of surgery.
Keywords: Magnetic resonance imaging, Rapid destructive osteoarthritis of the hip
SUPPORTING INFORMATION
Author Contributions
Kaja Johannson Oedegaard - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Rune Kvakestad - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Arild Aamodt - Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Mamad Adar - Substantial contributions to conception and design, Acquisition of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2019 Kaja Johannson Oedegaard et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
