Stress fracture and osteomyelitis in a patient with systemic lupus erythematosus

Avascular Necrosis Complicated by Osteomyelitis in a Lupus Patient With Active Renal Disease: A Case Report

This case highlights the importance of taking Systemic Lupus Erythematosus seriously and its possible concurrent musculoskeletal complications, as they can have significant health implications. Consulting and encouraging patients to adhere to the treatment is crucial. Although this case survived osteomyelitis without amputation, this outcome is rare and cannot be generalized.

Bone Involvement in Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by a wide variability of clinical manifestations due to the potential involvement of several tissues and internal organs, with a relapsing and remitting course. Dysregulation of innate and adaptive immune systems, due to genetic, hormonal and environmental factors, may be responsible for a broad spectrum of clinical manifestations, affecting quality of life, morbidity and mortality. Bone involvement represents one of the most common cause of morbidity and disability in SLE. Particularly, an increased incidence of osteoporosis, avascular necrosis of bone and osteomyelitis has been observed in SLE patients compared to the general population. Moreover, due to the improvement in diagnosis and therapy, the survival of SLE patient has improved, increasing long-term morbidities, including osteoporosis and related fractures. This review aims to highlight bone manifestations in SLE patients, deepening underlying etiopathogenetic mechanisms, diagnostic tools and available treatment.

Myositis, Osteomyelitis and a Parasymphyseal Stress Fracture in a Paediatric Patient

The limping child and painful hip are common presentations in many paediatric emergency units. Typically caused by mild self-limiting events, less commonly, they may be implicated in one of a group of inflammatory myopathies, or myositis. Diagnosis of this condition can be extremely difficult, and is aided by thorough clinical assessment, radiological imaging, and extensive blood serum testing. Myositis with associated osteomyelitis and a pathological fracture is an incredibly rare finding, described in this case report in a seven-year-old child. 

Hip pain in childhood

Abstract Hip pain in a child can have infectious, inflammatory, traumatic, neoplastic, or developmental causes, which can make the diagnosis challenging. Meticulous history taking and a detailed clinical examination guide the radiological investigation. In this article, we address some of the main causes of hip pain in childhood and their findings on diagnostic imaging.