Acute Pyogenic Osteomyelitis of the Pubic Bone in a Patient with Systemic Lupus Erythematosus Mimicking Fracture of the Pubic Bone and Periprosthetic Joint Infection of the Hip

Introduction. Pubic bone osteomyelitis is atypical, and the diagnosis is often overlooked. It may present as osteitis pubis, fracture, or noninfectious inflammation of the pubic symphysis. Case Report. We report a case of a 65-year-old lady who has systemic lupus erythematosus with acute pyogenic osteomyelitis of the pubic bone who presented initially with a suspicious healing pubic rami fracture and periprosthetic infection of the hip joint. Conclusion. Acute osteomyelitis of the pubic bone has often an infrequent and delayed presentation. Clinical awareness, early diagnosis, and appropriate treatment including surgical debridement and long-term antibiotics can prevent ongoing morbidities such as chronic osteomyelitis, pain, and deformities of pelvic bone and joints.

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Tendinous and Ligamentous Derangements in Systemic Lupus Erythematosus

The Journal of Rheumatology ◽

10.3899/jrheum.080255 ◽

2008 ◽

Vol 35 (11) ◽

pp. 2187-2191 ◽

Cited By ~ 12

Author(s):

GABRIELA SIERRA-JIMENEZ ◽

ADRIANA SANCHEZ-ORTIZ ◽

FRANCISCO JAVIER ACEVES-AVILA ◽

GUILLERMO HERNANDEZ-RIOS ◽

SERGIO DURÁN-BARRAGÁN ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Ct Scan ◽

Lupus Erythematosus ◽

Care Center ◽

Tertiary Care ◽

Radiographic Evaluation ◽

Systemic Lupus ◽

Osteitis Pubis ◽

Common Framework ◽

Grade Iii

ObjectiveWe assessed the prevalence of selected clinical and radiological features of tendinous and ligamentous derangements in a consecutive sample of patients with systemic lupus erythematosus (SLE).MethodsConsecutive patients with SLE with no comorbidities attending a tertiary care center were prospectively assessed and underwent plain radiographic evaluation of the pelvis. Radiographs were analyzed by 2 blinded observers; radiographic sacroiliitis was graded 0 to IV. To better assess sacroiliac (SI) involvement, a computed tomography (CT) scan of the SI joints was performed in patients with grade III sacroiliitis. Hip joints and pubis were also assessed as described.ResultsOf the 192 included patients, 89% were female, mean age was 36 years, and mean disease duration was 10 years. Inflammatory low back pain was reported by 10% of patients. Sacroiliitis of any grade was observed in 31 patients (16%), and grade III (confirmed on CT scan) sacroiliitis was observed in 6% (95% CI 3% to 9%). Osteitis pubis was diagnosed in 6% (95% CI 3% to 10%) and coxofemoral migration in 8% (95% CI 2% to 9%). Jaccoud’s arthropathy was found in 23%. Demographic and clinical variables were not statistically associated with radiographic sacroiliitis.ConclusionSacroiliitis and other tendinous and ligamentous derangements are not uncommon in patients with SLE. Based on these features and on previous reports, the term “SLE-related tendinous and ligamentous derangements” may be used to establish a common framework for further research and reporting.

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Organized Intraglomerular Deposits in NZB Mouse Disease

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100066772 ◽

1971 ◽

Vol 29 ◽

pp. 544-545

Author(s):

Francis R. Comerford ◽

Alan S. Cohen

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Antinuclear Antibodies ◽

Human Systemic Lupus Erythematosus ◽

Systemic Lupus ◽

Glomerular Lesion ◽

Ultrastructural Studies ◽

Dense Deposits ◽

Experimental Nephritis ◽

Glomerular Lesions

Mice of the inbred NZB strain develop a spontaneous disease characterized by autoimmune hemolytic anemia, positive lupus erythematosus cell tests and antinuclear antibodies and nephritis. This disease is analogous to human systemic lupus erythematosus. In ultrastructural studies of the glomerular lesion in NZB mice, intraglomerular dense deposits in mesangial, subepithelial and subendothelial locations were described. In common with the findings in many examples of human and experimental nephritis, including many cases of human lupus nephritis, these deposits were amorphous or slightly granular in appearance with no definable substructure.We have recently observed structured deposits in the glomeruli of NZB mice. They were uncommon and were found in older animals with severe glomerular lesions by morphologic criteria. They were seen most commonly as extracellular elements in subendothelial and mesangial regions. The deposits ranged up to 3 microns in greatest dimension and were often adjacent to deposits of lipid-like round particles of 30 to 250 millimicrons in diameter and with amorphous dense deposits.

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