患儿,女,13岁,因背痛加重急诊,背痛辐射到右臀区、右腿,入院前6天,患儿有过度劳累。在随后的几天里,患儿出现发热,达40°C,遂来急诊。经检查,患者右臀区、臀沟部疼痛,大腿内旋内收。由于疼痛,没有评估步态。患儿自述右下肢感觉异常。入院时,体温为37.0°C。入院时实验室检查:白细胞(WBC)计数为19.75x10*9/L(L),红细胞沉降率(ESR)为92mm/h,C反应蛋白(CRP)为mg/L。尿常规未见异常。右髋MRI/增强显示右侧椎旁肌肉组织弥漫性水肿,但未见脓肿。患者因右椎旁肌炎入院。腰椎MRI显示L3-S1的硬膜外脓肿,伴有囊状积脓和神经根的压迫,此时患者接受急诊手术治疗(图1)。
A13-year-oldfemalepresentedtotheemergencyroomworseningbackpainradiatingtotherightglutealregionandpainradiatingdowntherightlegwithonsetassociatedwithoverusesixdayspriortoadmission.Patientbecamefebrileinthefollowingdayswithamaximumtemperatureof40°Celsius(C)beforepresentingtotheemergencydepartment.Uponexamination,thepatienthadpaininrightglutealregion,glutealcleft,andwithinternalrotationandadductionofbilateralhips.Gaitwasnotassessedduetopain.Patient