Subacute Femoral Neck Osteomyelitis with Torpid Evolution and Undiagnosed at the Onset: Chronic Pain and Pathological Bone Fracture: A Case Study
Asfandiyar Khan Mohmand
Department of Internal Medicine, Khyber Teaching Hospital, Peshawar, Pakistan.
Haris Pasha
Department of Internal Medicine, Shifa International Hospital, Islamabad, Pakistan.
Waqar Ali Shah
Department of General Medicine, Saidu Teaching Hospital, Swat, Pakistan.
Zeeshan Nawaz
Department of Pediatric Oncology, Shaukat Khanum Memorial Hospital, Peshawar, Pakistan.
Basharat Ullah
Department of Basic Medical Sciences, Bahria University, Islamabad, Pakistan.
Jibran Ikram
Department of Medicine, Rahman Medical Institution, Peshawar, Pakistan.
Atif Sardar
Department of Medicine, Roshan Hospital Saidu Sharif, Swat, Pakistan.
Talha Mohiuddin
Department of Internal Medicine, Shifa International Hospital, Islamabad, Pakistan.
Khayyam Haider
Department of Medicine, Lady Reading Hospital, Peshawar, Pakistan.
Laiba Malak
Department of Rheumatology, Pakistan International Hospital, Islamabad, Pakistan.
Abdul Latif
Department of Medicine, Lady Reading Hospital, Peshawar, Pakistan.
Furqan Ul Haq *
Department of Radiation Oncology, Shaukat Khanum Hospital, Peshawar, Pakistan.
*Author to whom correspondence should be addressed.
Abstract
Background: Chronic pain is a persistent and among most prevalence issue in childhood the bio psychosocial model of pain which is a complex interplay contributes to pain symptoms. Disability has guided our understanding and treatment of pediatric pain. The exact cause of chronic pain is sometimes infectious.
Introduction: The inclusion of chronic pain and rehabilitation terms resulted in a search to treat pediatric pain, treatment requires a comprehension and multi-disciplinary approaches mostly relieved by psychological intervention. Currently it is unclear how accurate diagnosis is made by general practitioners and specialists and how evaluation is made by pain specialists can affect patient’s outcomes.
Case: A young adult female whose chronic hip and knee pain from several months was treated for pain, and osteoporosis, and osteomalacia, with calcium supplements, once Magnetic resonance imaging was done, it revealed that the patient is having fluid filled space in left hip when biopsied revealed chronic osteomyelitis.
Conclusion: Chronic pain in pediatrics may be associated to osteomalacia, or osteopenia, it may be infectious, may be due to malignancy or fracture, but it shall be investigated with MRI na biopsy if the pain persists and not reliving with analgesics and supplements. Ignorance of chronic osteomyelitis can have poor outcomes.
Keywords: Pediatric pain, chronic pain, chronic osteomyelitis, Staph aureus, MRSA