Osteonecrosis with Concomitant Septic Arthritis of Bilateral Hips following Severe COVID-19 Infection: A Case Report
Introduction: Among the various musculoskeletal manifestations of post-acute Coronavirus disease 2019 (COVID-19) syndrome, osteonecrosis and pyogenic infections are of serious concern due to their potential for joint destruction and the need for major surgery, even among young patients. Spontaneous...
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| Format: | Article |
| Language: | English |
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Indian Orthopaedic Research Group
2025-02-01
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| Series: | Journal of Orthopaedic Case Reports |
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| Online Access: | https://jocr.co.in/wp/2025/02/01/osteonecrosis-with-concomitant-septic-arthritis-of-bilateral-hips-following-severe-covid-19-infection-a-case-report/ |
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| author | Apurve Parameswaran Murtuza A Mohammed Deepak Gautam Rajesh Malhotra Sunil Apsingi Krishna K Eachempati |
| author_facet | Apurve Parameswaran Murtuza A Mohammed Deepak Gautam Rajesh Malhotra Sunil Apsingi Krishna K Eachempati |
| author_sort | Apurve Parameswaran |
| collection | DOAJ |
| description | Introduction:
Among the various musculoskeletal manifestations of post-acute Coronavirus disease 2019 (COVID-19) syndrome, osteonecrosis and pyogenic infections are of serious concern due to their potential for joint destruction and the need for major surgery, even among young patients. Spontaneous septic arthritis is rare among healthy adults. Very few cases of osteonecrosis of the femoral heads (ONFH) with concomitant septic arthritis of the hip following a COVID-19 infection are reported in the literature.
Case Report:
We report the case of a 43-year-old male patient, who presented with bilateral ONFHs and concomitant septic arthritis of the hips (caused by Pseudomonas aeruginosa), 8 weeks following a severe COVID-19 infection. His serum inflammatory markers were elevated. Radiologic findings were equivocal, and suggestive of osteonecrosis, with possible septic arthritis of the hip. In view of disabling end-stage arthritis, he was advised bilateral total hip arthroplasty (THA), in one or two stages, depending on the intraoperative findings. The diagnosis of infection was confirmed through intraoperative frozen section analysis. Bilateral two-staged THA was performed. At 3 years’ follow-up, the patient had no recurrence of symptoms, and was found to be doing well, with a Harris Hip Score of 93 points, and no limb length discrepancy.
Conclusion:
COVID-19 infection predisposes patients to the development of ONFH. Concomitant septic arthritis of the hip, however, is scarcely reported, and needs to be ruled out in cases with rapid progression of symptoms. |
| format | Article |
| id | doaj-art-164bbbbf17cf42e089a80e47d733ad7b |
| institution | OA Journals |
| issn | 2250-0685 2321-3817 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Indian Orthopaedic Research Group |
| record_format | Article |
| series | Journal of Orthopaedic Case Reports |
| spelling | doaj-art-164bbbbf17cf42e089a80e47d733ad7b2025-08-20T02:36:42ZengIndian Orthopaedic Research GroupJournal of Orthopaedic Case Reports2250-06852321-38172025-02-01152656910.13107/jocr.2025.v15.i02.5230Osteonecrosis with Concomitant Septic Arthritis of Bilateral Hips following Severe COVID-19 Infection: A Case ReportApurve ParameswaranMurtuza A MohammedDeepak GautamRajesh MalhotraSunil ApsingiKrishna K EachempatiIntroduction: Among the various musculoskeletal manifestations of post-acute Coronavirus disease 2019 (COVID-19) syndrome, osteonecrosis and pyogenic infections are of serious concern due to their potential for joint destruction and the need for major surgery, even among young patients. Spontaneous septic arthritis is rare among healthy adults. Very few cases of osteonecrosis of the femoral heads (ONFH) with concomitant septic arthritis of the hip following a COVID-19 infection are reported in the literature. Case Report: We report the case of a 43-year-old male patient, who presented with bilateral ONFHs and concomitant septic arthritis of the hips (caused by Pseudomonas aeruginosa), 8 weeks following a severe COVID-19 infection. His serum inflammatory markers were elevated. Radiologic findings were equivocal, and suggestive of osteonecrosis, with possible septic arthritis of the hip. In view of disabling end-stage arthritis, he was advised bilateral total hip arthroplasty (THA), in one or two stages, depending on the intraoperative findings. The diagnosis of infection was confirmed through intraoperative frozen section analysis. Bilateral two-staged THA was performed. At 3 years’ follow-up, the patient had no recurrence of symptoms, and was found to be doing well, with a Harris Hip Score of 93 points, and no limb length discrepancy. Conclusion: COVID-19 infection predisposes patients to the development of ONFH. Concomitant septic arthritis of the hip, however, is scarcely reported, and needs to be ruled out in cases with rapid progression of symptoms.https://jocr.co.in/wp/2025/02/01/osteonecrosis-with-concomitant-septic-arthritis-of-bilateral-hips-following-severe-covid-19-infection-a-case-report/severe acute respiratory syndromecoronavirus disease 2019osteonecrosisseptic arthritispost-acute coronavirus disease 2019 syndrome |
| spellingShingle | Apurve Parameswaran Murtuza A Mohammed Deepak Gautam Rajesh Malhotra Sunil Apsingi Krishna K Eachempati Osteonecrosis with Concomitant Septic Arthritis of Bilateral Hips following Severe COVID-19 Infection: A Case Report Journal of Orthopaedic Case Reports severe acute respiratory syndrome coronavirus disease 2019 osteonecrosis septic arthritis post-acute coronavirus disease 2019 syndrome |
| title | Osteonecrosis with Concomitant Septic Arthritis of Bilateral Hips following Severe COVID-19 Infection: A Case Report |
| title_full | Osteonecrosis with Concomitant Septic Arthritis of Bilateral Hips following Severe COVID-19 Infection: A Case Report |
| title_fullStr | Osteonecrosis with Concomitant Septic Arthritis of Bilateral Hips following Severe COVID-19 Infection: A Case Report |
| title_full_unstemmed | Osteonecrosis with Concomitant Septic Arthritis of Bilateral Hips following Severe COVID-19 Infection: A Case Report |
| title_short | Osteonecrosis with Concomitant Septic Arthritis of Bilateral Hips following Severe COVID-19 Infection: A Case Report |
| title_sort | osteonecrosis with concomitant septic arthritis of bilateral hips following severe covid 19 infection a case report |
| topic | severe acute respiratory syndrome coronavirus disease 2019 osteonecrosis septic arthritis post-acute coronavirus disease 2019 syndrome |
| url | https://jocr.co.in/wp/2025/02/01/osteonecrosis-with-concomitant-septic-arthritis-of-bilateral-hips-following-severe-covid-19-infection-a-case-report/ |
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