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Pelvic osteomyelitis and other infections of the bony pelvis in adults

Author
Daniel J Sexton, MD
Section Editor
Stephen B Calderwood, MD
Deputy Editor
Elinor L Baron, MD, DTMH

INTRODUCTION

Infections of the bones and joints of the pelvis may arise hematogenously, secondary to trauma or surgery via direct inoculation of pathogens into bone, or via contiguous spread of infection from soft tissues within or outside the bony walls of the pelvis. These infections may manifest as pelvic osteomyelitis or septic arthritis with contiguous spread to the adjacent bony margins.

Issues related to pelvic osteomyelitis and septic arthritis of the two principle joints of the pelvis (the pubic symphysis and sacroiliac joint) will be reviewed here.

General issues related to the pathogenesis and classification of osteomyelitis and the clinical features of other types of osteomyelitis are discussed separately. (See "Overview of osteomyelitis in adults" and "Pathogenesis of osteomyelitis" and "Treatment and prevention of osteomyelitis following trauma in adults" and "Hematogenous osteomyelitis in adults".)

Nonsuppurative processes involving the sacroiliac joint are discussed separately. (See "Clinical manifestations of ankylosing spondylitis in adults" and "Arthritis associated with gastrointestinal disease".)

Clinical manifestations of osteomyelitis and septic arthritis are discussed separately. (See "Overview of osteomyelitis in adults" and "Septic arthritis in adults".)

           

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Literature review current through: Nov 2016. | This topic last updated: Thu Sep 29 00:00:00 GMT+00:00 2016.
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References
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  1. Ukwu HN, Graham BS, Latham RH. Acute pubic osteomyelitis in athletes. Clin Infect Dis 1992; 15:636.
  2. Kaplon DM, Iannotti H. Prostatic capsular perforation with extravasation resulting in pubic osteomyelitis: a rare complication of KTP laser prostatectomy. J Endourol 2008; 22:2705.
  3. Graham CW, Dmochowski RR, Faerber GJ, et al. Pubic osteomyelitis following bladder neck surgery using bone anchors: a report of 9 cases. J Urol 2002; 168:2055.
  4. Dinan JJ. TWO CASES OF PRIMARY OSTEOMYELITIS OF THE PUBIC BONE. Can Med Assoc J 1939; 41:436.
  5. Guthrie R, Monk J. Osteomyelitis of the symphysis pubis: a complication of cardiac catheterisation. Br J Clin Pract 1989; 43:383.
  6. Bodavula P, Liang SY, Wu J, et al. Pressure Ulcer-Related Pelvic Osteomyelitis: A Neglected Disease? Open Forum Infect Dis 2015; 2:ofv112.
  7. Dourakis SP, Alexopoulou A, Metallinos G, et al. Pubic osteomyelitis due to Klebsiella pneumoniae in a patient with diabetes mellitus. Am J Med Sci 2006; 331:322.
  8. Highland TR, LaMont RL. Osteomyelitis of the pelvis in children. J Bone Joint Surg Am 1983; 65:230.
  9. Ross JJ, Hu LT. Septic arthritis of the pubic symphysis: review of 100 cases. Medicine (Baltimore) 2003; 82:340.
  10. Sexton DJ, Heskestad L, Lambeth WR, et al. Postoperative pubic osteomyelitis misdiagnosed as osteitis pubis: report of four cases and review. Clin Infect Dis 1993; 17:695.
  11. Takemoto RC, Strongwater AM. Pelvic osteomyelitis mimicking septic hip arthritis: a case report. J Pediatr Orthop B 2009; 18:248.
  12. Beaupré A, Carroll N. The three syndromes of iliac osteomyelitis in children. J Bone Joint Surg Am 1979; 61:1087.
  13. Yoshida S, Nakagomi K, Goto S. Abscess formation in the prevesical space and bilateral thigh muscles secondary to osteomyelitis of the pubis--basis of the anatomy between the prevesical space and femoral sheath. Scand J Urol Nephrol 2004; 38:440.
  14. del Busto R, Quinn EL, Fisher EJ, Madhavan T. Osteomyelitis of the pubis. Report of seven cases. JAMA 1982; 248:1498.
  15. Bindal M, Krabak B. Acute bacterial sacroiliitis in an adult: a case report and review of the literature. Arch Phys Med Rehabil 2007; 88:1357.
  16. Beer E. Periostitis and ostitis of the symphysis and rami of the pubis following suprapubic cystotomies. Int J Med Surg 1924; 237:233.
  17. Rosenthal RE, Spickard WA, Markham RD, Rhamy RK. Osteomyelitis of the symphysis pubis: a separate disease from osteitis pubis. Report of three cases and review of the literature. J Bone Joint Surg Am 1982; 64:123.
  18. Apostolis CA, Heiselman C. Sacral osteomyelitis after laparoscopic sacral colpopexy performed after a recent dental extraction: a case report. Female Pelvic Med Reconstr Surg 2014; 20:e5.
  19. Iavazzo C, Gkegkes ID. Osteomyelitis after robotically assisted laparoscopic sacral colpopexy. Acta Inform Med 2013; 21:143.
  20. Wittum S, Hofer CK, Rölli U, et al. Sacral osteomyelitis after single-shot epidural anesthesia via the caudal approach in a child. Anesthesiology 2003; 99:503.
  21. Charles P, Ackermann F, Brousse C, et al. [Spontaneous streptococcal arthritis of the pubic symphysis]. Rev Med Interne 2011; 32:e88.
  22. Holden W, David J. Chronic recurrent multifocal osteomyelitis: two cases of sacral disease responsive to corticosteroids. Clin Infect Dis 2005; 40:616.
  23. COVENTRY MB, MITCHELL WC. Osteitis pubis: observations based on a study of 45 patients. JAMA 1961; 178:898.
  24. Choi H, McCartney M, Best TM. Treatment of osteitis pubis and osteomyelitis of the pubic symphysis in athletes: a systematic review. Br J Sports Med 2011; 45:57.
  25. Rennert R, Golinko M, Yan A, et al. Developing and evaluating outcomes of an evidence-based protocol for the treatment of osteomyelitis in Stage IV pressure ulcers: a literature and wound electronic medical record database review. Ostomy Wound Manage 2009; 55:42.
  26. Janis JE, Ahmad J, Lemmon JA, et al. A 25-year experience with hemicorporectomy for terminal pelvic osteomyelitis. Plast Reconstr Surg 2009; 124:1165.