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Spontaneous obturator internus muscle haematoma: a new unpublished cause of ilioipelvic pain in haemophilia.
[pyomyositis]
Obturator
muscles
haematoma
are
rarely
reported
.
The
most
often
reported
cases
are
primary
pyomyositis
or
posttraumatic
haematomas
occurring
during
pelvic
fractures
.
We
firstly
report
herein
two
cases
of
spontaneous
obturator
internus
haematoma
(
OIH
)
in
two
haemophiliacs
with
inhibitor
.
Clinical
data
and
imaging
of
two
patients
treated
in
our
clinic
are
reported
here
according
to
previously
defined
criteria
of
OIH
in
posttraumatic
situation
.
Both
patients
were
children
suffering
from
severe
and
moderate
haemophilia
A
,
respectively
,
with
an
inhibitor
at
the
time
of
the
event
.
The
clinical
feature
was
marked
by
an
iliopelvic
pain
letting
discussing
hip
haemarthrosis
,
appendicitis
or
iliopsoas
haematoma
.
For
both
patients
ultrasonography
(
US
)
failed
to
provide
the
diagnosis
.
Careful
and
repeated
clinical
examinations
eventually
lead
to
suspect
obturator
haematoma
which
was
confirmed
by
abdominopelvic
computed
tomography
(
CT
)
and
magnetic
resonance
imaging
(
MRI
)
.
Respectively
,
high
dose
of
FVIII
or
rFVIIa
regimen
allowed
a
rapid
control
of
the
muscular
bleeding
in
the
low
and
high
responder
inhibitor
patients
.
Spontaneous
OIH
may
be
added
to
the
differential
diagnosis
of
iliopelvic
pain
in
severe
forms
of
haemophilia
.
US
still
often
performed
at
first
in
such
case
remains
unhelpful
;
abdominopelvic
CT
or
MRI
should
be
performed
to
discriminate
among
different
diagnoses
,
including
OIH
which
stays
probably
undiagnosed
.
Diseases
Validation
Diseases presenting
"pain"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
adrenomyeloneuropathy
aniridia
aromatase deficiency
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital diaphragmatic hernia
congenital toxoplasmosis
cushing syndrome
cutaneous mastocytosis
cystinuria
dedifferentiated liposarcoma
dentin dysplasia
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
fabry disease
familial mediterranean fever
focal myositis
hirschsprung disease
hodgkin lymphoma, classical
holt-oram syndrome
junctional epidermolysis bullosa
kabuki syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
malignant atrophic papulosis
neuralgic amyotrophy
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
phenylketonuria
pleomorphic liposarcoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
scrub typhus
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
trochlear dysplasia
typhoid
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
wolf-hirschhorn syndrome
This symptom has already been validated