Prosthetic Hip Joint Infection of Digestive Origin, Diagnosis of a Rare but Serious Condition: A Case Report

J Orthop Case Rep. 2023 Jul;13(7):140-144. doi: 10.13107/jocr.2023.v13.i07.3786.

Abstract

Introduction: Prosthetic joint infection (PJI) is a relatively infrequent occurrence; however, it always poses a significant risk to the patient's functional outcome. The origin of PJI is often a topic of debate. In this case, we present a PJI that resulted from a digestive fistula passing through an iliopsoas abscess, which can be regarded as an unusual consequence of rare conditions.

Case report: A 72-year-old man was brought to the emergency department with pain in his right hip and a functional impairment of his right lower limb. This had been ongoing for 3 weeks and he had no history of trauma or fever. An initial X-ray was negative for fracture, but a computed tomography scan showed a large collection of liquid and gas in his psoas major muscle extending to the right prosthetic hip. The origin of the collection was from the digestive tract. It was caused by his fistula that brought the intestinal lumen in contact with the patient's prosthetic hip through the psoas major muscle and caused a PJI.

Conclusion: The interconnectivity of various medical disciplines is exemplified by this case, where a digestive fistula resulted in an infection of a prosthetic hip. It is essential for both the orthopedic and general surgeons to recognize that a digestive fistula can pose a threat to a prosthetic hip.

Keywords: Prosthetic hip infection; digestive tract; fistula; psoas abscess.

Publication types

  • Case Reports