Spontaneous Obturator Internus Hematoma-a Rare Cause of Hip Pain: Case Report

Abstract

Introduction: Obturator internus hematoma(OIH) is a very rare entity. In past it has been reported in hemophilics, we firstly report obturator internus hematoma in a patient of stroke on antiplatelet drugs. Obturator internus hematoma can cause severe hip pain with normal X-rays, so it should kept in differential diagnosis of hip pain with normal radiographs.

Case report: 74 year old male with history of recent onset stroke presented to us with left side weakness and left hip pain. Radiographs were normal. MRI revealed left obturator internus hematoma. Patient was treated conservatively by stopping antiplatelet medications.

Conclusion: Obturator internus hematoma is very rare but very important entity to recognise as it may mimic myositis or abscess around hip joint. Failing to recognize it and treating patient surgically may lead to untoward consequences.

Keywords: Obturator internus; Obturator internus hematoma; antiplatelet drugs; muscle abcess.

Figure 1

T2 fatsat axial image reveal bulky and heterogeneous signal intensity left Obturator internus muscle. Incidentally seen left inguinal hernia

Figure 2

T1 axial image reveal bulky and iso to slightly hyperintense left Obturator internus muscle

Figure 3

T2 coronal image reveal heterogeneous collection in left Obturator internus muscle.

Figure 4

Post contrast T1 fat sat axial image reveal minimal peripheral enhancement of collection in bulky obturator internus muscle.