Munazzah Kaleem Alexander Newell Wendy Phillips Saravanan Balamuthusamy
HCA Healthcare
01-01-2025
Background/Intro Tumor calcinosis is a rare disease, and its association with greater trochanteric pain syndrome, abscess formation, and Osteomyelitis has not been well studied. Case presentation ..
Background/Intro Tumor calcinosis is a rare disease, and its association with greater trochanteric pain syndrome, abscess formation, and Osteomyelitis has not been well studied. Case presentation A 63-year-old woman with a known history of tumor calcinosis presents with right hip pain for 5 days. She woke up with a pain that was constant, alleviated with resting and getting worse with exertion and rolling on that side. She reports a t-max of 101F. Ct scan revealed a 9 x 4 x 11cm rim enhancing right great trochanteric collection and/ or severe bursitis. Orthopedic surgery evaluated the patient and, had low suspicion of infection. They also discussed the IR-guided aspiration but it was ultimately deferred and she was discharged home on a Medrol dose pack for possible inflammation. The patient presented again 2 days later with drainage from the site. WBC count was significant at 32.9 and a repeat CT scan showed a right lateral hip soft tissue abscess of 3.6 x 3.0 x 8.4 soft tissue fluid collection with a thick, mildly enhancing rim, an overlying cutaneous defect, and sinus transit. MRI showed osteomyelitis of the lateral aspect of the right greater trochanter. Wound culture grew MSSA. The patient was started on antibiotics which resolved the symptoms and was discharged home on long-term IV antibiotics. Pt has a history of tumor calcinosis resection in 2018 with mild removal of muscle mass on the right hip joint. Which was complicated by mRSA and Klebsiella at that time and the patient fully recovered after 8 months long treatment. Discussion Recurrent multifocal osteomyelitis has been reported earlier in patients with tumor calcinosis, but no association between tumor calcinosis and episodes of osteomyelitis years after surgery has been reported so far. Teaching/Learning Points Patients with tumor calcinosis can often present with osteomyelitis which can be overseen as bursitis.