Articles | Volume 9, issue 3
https://doi.org/10.5194/jbji-9-167-2024
© Author(s) 2024. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
https://doi.org/10.5194/jbji-9-167-2024
© Author(s) 2024. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
Case report
| 
13 Jun 2024
Case report |
| 13 Jun 2024
| 13 Jun 2024
Ureaplasma urealyticum osteomyelitis of the greater trochanter in a patient with multiple sclerosis using ocrelizumab – a case report
Fred Ruythooren
CORRESPONDING AUTHOR
Department of Orthopaedic Surgery, University Hospitals Leuven – Gasthuisberg, Leuven, Belgium
Institute for Orthopaedic Research and Training (IORT), University Hospitals Leuven – Gasthuisberg, Leuven, Belgium
Stijn Ghijselings
Department of Orthopaedic Surgery, University Hospitals Leuven – Gasthuisberg, Leuven, Belgium
Institute for Orthopaedic Research and Training (IORT), University Hospitals Leuven – Gasthuisberg, Leuven, Belgium
Melissa Depypere
Department of Laboratory Medicine, University Hospitals Leuven – Gasthuisberg, Leuven, Belgium
Willem-Jan Metsemakers
Department of Trauma Surgery, University Hospitals Leuven – Gasthuisberg, Leuven, Belgium
Department of Development and Regeneration, KU Leuven, Leuven, Belgium
Liesbet Henckaerts
Department of Microbiology, Immunology and Transplantation, Laboratory for Clinical Infectious and Inflammatory Disorders, KU Leuven, Leuven, Belgium
Department of General Internal Medicine, University Hospitals Leuven – Gasthuisberg, Leuven, Belgium
Nathalie Noppe
Department of Radiology, University Hospitals Leuven – Gasthuisberg, Leuven, Belgium
Georges Vles
CORRESPONDING AUTHOR
Department of Orthopaedic Surgery, University Hospitals Leuven – Gasthuisberg, Leuven, Belgium
Institute for Orthopaedic Research and Training (IORT), University Hospitals Leuven – Gasthuisberg, Leuven, Belgium
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Septic arthritis (SA) of the native adult hip is a rare orthopaedic emergency. To date, the role of advanced imaging has been confined to supporting or opposing diagnosis; however, implications for surgical decision-making and outcomes have not yet been established. We found that extra-articular abscesses are present in two out of three patients and require varying anatomical approaches. Therefore, we recommend routinely performing advanced imaging in all adults with SA of the native hip joint.
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A total of 41 patients who underwent surgical treatment for septic arthritis (SA) of the native hip were studied. We show that patients with SA of the native hip can be divided in three distinct clinical subgroups based on route of infection. Route of infection is directly related to the chance of femoral head preservation and should, therefore, be the basis for decision-making. Only patients with blood-borne infections in an undamaged hip had a reasonable chance of femoral head preservation.
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Short summary
The article examines a unique case of Ureaplasma urealyticum causing osteomyelitis in the greater trochanter of a 26-year-old male treated with ocrelizumab for multiple sclerosis. It emphasizes the necessity of a multidisciplinary approach and advanced PCR diagnostics to manage such rare opportunistic infections effectively, highlighting the challenges faced due to the immunosuppressive nature of monoclonal antibody therapies of this kind.
The article examines a unique case of Ureaplasma urealyticum causing osteomyelitis in the...
