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Groin pain in the postradiotherapy pelvis: have you considered osteomyelitis?
  1. Aryeh Dworkin1,
  2. Ehsan Riaz1 and
  3. Nikhil Vasdev2
  1. 1Accident and Emergency, West Hertfordshire Teaching Hospitals NHS Trust, Watford, UK
  2. 2Urology, Lister Hospital, East and North Hertfordshire NHS Trust, Stevenage, UK
  1. Correspondence to Dr Aryeh Dworkin; aryeh.dworkin{at}nhs.net

Abstract

A man in his 80s presented to the emergency department with a 5-week history of lower abdominal and groin pain which had substantially affected his mobility. He practised intermittent self-catheterisation following radiotherapy for prostate cancer. Multiple suggestive features led to initial treatment for a urinary tract infection (UTI). However, CT imaging revealed pubic symphysis osteomyelitis with associated abdominal wall abscesses and fistulation to the prostate. This case illustrates the need to consider osteomyelitis as a differential for pain in previously irradiated body areas and to beware of diagnosing UTI where pain affects mobility.

  • Bone and joint infections
  • Urinary tract infections
  • Prostate Cancer
  • Radiotherapy

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Footnotes

  • Contributors AD acquired the data and drafted the report. The data were jointly interpreted with ER and NV who provided critical review and revision of the report. All three were involved in the care of the study patient.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.