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J Bone Joint Surg Am.
J. Bickels, L. Ben-Sira, A. Kessler and S. Wientroub
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The Journal of Bone and Joint Surgery
COPYRIGHT © 2002 BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED
Current Concepts Review
BY J. BICKELS, MD, L. BEN-SIRA, MD, A. KESSLER, MD, AND S. WIENTROUB, MD
Investigation performed at the Departments of Pediatric Orthopaedics and Radiology, Dana Children’s Hospital,
Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
➤ Primary pyomyositis is a rare, subacute, primary muscle infection that is probably the result of a transient bacte-
remia in most patients.
➤ The quadriceps, gluteal, and iliopsoas muscles are the most commonly affected anatomic sites.
➤ Staphylococcus aureus is the culpable bacteria in >75% of cases.
➤ There are three consecutive stages of the disease: diffuse muscle infection, abscess formation, and sepsis.
➤ Magnetic resonance imaging is the preferred diagnostic imaging modality.
➤ Treatment includes complete drainage of any abscess cavity combined with appropriate antibiotic therapy. Drain-
age is performed either by open surgical exposure or by needle aspiration guided by computerized tomography or
➤ Most patients have