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Case Reports in Orthopedics
Volume 2016, Article ID 3179621, 4 pages
http://dx.doi.org/10.1155/2016/3179621
Case Report

Unusual MRI Findings in a Polio Survivor

1Department of Orthopaedic Surgery, Chiba Aoba Municipal Hospital, 1273-2 Aoba-cho, Chuo-ku, Chiba 260-0852, Japan
2Department of Pathology, Chiba Aoba Municipal Hospital, 1273-2 Aoba-cho, Chuo-ku, Chiba 260-0852, Japan
3Department of Orthopaedic Surgery, Chiba Cancer Center, 666-2 Nitona-cho, Chuo-ku, Chiba 260-0801, Japan

Received 24 January 2016; Accepted 1 March 2016

Academic Editor: Giulio Maccauro

Copyright © 2016 Masaaki Sakamoto et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 63-year-old male consulted our institution due to worsening of right hip pain for approximately one month. The patient had no apparent functional disorders besides rigidity of the right ankle secondary to childhood poliomyelitis. Plain radiographs demonstrated narrowing of the right hip joint space. Magnetic resonance imaging (MRI) showed unusual findings in the right gluteus medius muscle, suspecting a malignant musculoskeletal tumor. Further examinations clarified acute inflammation caused by Staphylococcus aureus with no atypia. After treatment, serum inflammatory markers normalized and MRI showed homogeneous fat signal intensity in the muscle, which was consistent with poliomyelitis. Total hip arthroplasty was performed due to progression of osteoarthritis. Intraoperative findings showed flaccidity of the gluteus medius muscle, and histological examination of the specimen also was compatible with poliomyelitis. Postoperatively there was no hip instability and the patient has been able to resume his previous physical activity. To our knowledge, this is the first report regarding polio survivors combined with septic arthritis, and sole MRI examination was unable to lead to the diagnosis. The current patient demonstrates the possibility that the involved muscles in poliomyelitis exist even in asymptomatic regions, which will be helpful for accurate diagnosis and life guidance in polio survivors.