Lameness in freshwater turtles is rarely seen and is mostly caused by bite injuries, other traumata or inflammatory processes. A 17 year old female eastern river cooter which was pretreated for disseminated shell necrosis a few months ago was presented due to acute lameness of the right hind limb. Diagnostic imaging revealed complete lysis of the hip joint and was classified as necrotizing osteomyelitis by histopathology. Septicemic spreading of pathogens and thus a link to the previous shell necrosis could not be identified. The patient developed wound complications and died a few days after the surgical procedure. Postmortem, a pronounced subacute pneumonia was diagnosed as presumed cause of death, which has not been clinically manifest during the whole medical history.