Intraosseous fat necrosis simulating septic arthritis and osteomyelitis in a patient with chronic pancreatitis

A woman with a 20-year history of alcohol abuse and chronic pancreatitis developed an osteoarticular involvement of her right ankle in association with subcutaneous nodules. Histopathological examination of the tissue samples obtained during surgical revision of the ankle showed necrotic fat and con...

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Bibliographic Details
Published in:Archives of orthopaedic and trauma surgery 1998-12, Vol.118 (3), p.174-175
Main Authors: KOTILAINEN, P, SAARIO, R, MATTILA, K, NYLAMO, E, AHO, H
Format: Article
Language:English
Subjects:
Alcohol abuse
Ankle
Ankle Joint
Arthritis
Arthritis, Infectious - diagnosis
Biological and medical sciences
Bone Diseases - complications
Bone Diseases - diagnosis
Diseases of the osteoarticular system
Fat Necrosis - complications
Fat Necrosis - diagnosis
Fatal Outcome
Female
Humans
Medical sciences
Middle Aged
Miscellaneous. Osteoarticular involvement in other diseases
Necrosis
Osteomyelitis - diagnosis
Pancreatitis
Pancreatitis, Alcoholic - complications
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Summary:A woman with a 20-year history of alcohol abuse and chronic pancreatitis developed an osteoarticular involvement of her right ankle in association with subcutaneous nodules. Histopathological examination of the tissue samples obtained during surgical revision of the ankle showed necrotic fat and connective tissue. Microbiological cultures remained negative. The patient was administered long-term antimicrobial treatment without any apparent benefit. Four months later, she died of pancreatic insufficiency and pneumonia. Postmortem examination showed numerous foci of intra-abdominal fat necrosis. Histopathological examination of the bone samples from the right ankle showed fat necrosis with lipophages. Based on these findings, we consider that the osteoarticular involvement in this patient was caused by intraosseous fat necrosis. This case reminds us of the importance of considering the possibility of this condition whenever a patient with chronic pancreatic disease develops sterile osteoarthritis.
ISSN:0936-8051
1434-3916
DOI:10.1007/s004020050342