Case Presentation: A 27 years old patient admitted from ambulatory care due to worsening pain of the left hip since 4 days on the background of intravenous drug abuse.
Examination: Examination revealed restricted movements of the left hip due to pain. However, there was no swelling or overlying skin changes.
Investigations: Laboratory investigations revealed significantly elevated inflammatory markers. The left hip joint radiography revealed decreased joint space. Ultrasonography of the left hip showed a slightly hetergenous anechoic collection in left hip. MRI showed synovial thickening and joint effusion.
Management: An urgent orthopedics opinion was sought who advised open irrigation and joint wash out.
Treatment: An urgent hip joint open irrigation and wash out was done and samples of joint effusion were sent for further investigations. Following procedure, the patient was put on empirical intravenous antibiotic. The synovial fluid analysis revealed significantly elevated white cell count and the culture results showed a mixed growth of staphylococcus aureus and Pseudomonas aeruginosa. The treatment was modified according to the sensitivity results the culture.
Outcome: Following joint wash out, the patient symptoms improved significantly.
Follow-up: A follow-up appointment was arranged at orthopedic clinic.