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Adolescent with an abrupt onset of muscle pain and fever
  1. Riccardo Barberini1,
  2. Antonella Luglio2,
  3. Alessandro De Fanti2,
  4. Lorenzo Iughetti1,3,
  5. Andrea Trombetta2
  1. 1 Medical and Surgical Sciences of Mother, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
  2. 2 Pediatrics, Azienda USL—IRCCS di Reggio Emilia, Reggio Emilia, Italy
  3. 3 Policlinico di Modena, Modena, Italy
  1. Correspondence to Dr Antonella Luglio; antonella.luglio{at}ausl.re.it

https://doi.org/10.1136/archdischild-2024-326878

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    Case

    An early-teen boy with spastic bilateral cerebral palsy predominantly affecting the lower limbs was admitted to hospital with a 12-hour history of fever and pain in the left thigh. Two months previously the patient had a biceps femoris and semimembranosus muscle fasciotomy and a tendon shortening procedure and had been on anticoagulation therapy. The pain presented following his initial mobilisation after this procedure. His previous medical history was remarkable for a low-grade fever 3 weeks previously, which resolved after a 7-day course of amoxicillin-clavulanic acid.

    The patient had a temperature of 38.2°C with a severe limitation in all ranges of movement of his knee, but he was able to weight bear as normal.

    Blood tests showed a white blood cells (WBC) of 13 560 x 10ˆ9/L, increased C reactive protein (CRP) level of 43.9 mg/L, a normal erythrocyte sedimentation rate (ESR), a haemoglobin of 103 gr/L and a platelets of 381 x 10ˆ9/L. Creatine kinase and coagulation tests (including D-dimer) were within the normal range.

    X-rays of the left hip and knee were unremarkable. An ultrasound scan showed …

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    Footnotes

    • Correction notice This paper has been corrected since it was first published. We have corrected the surname of one of the authors.

    • Contributors RB, AT and AL wrote the first draft of the manuscript. ADF and LL made the revision of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer-reviewed.