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Sentinel Presentation of Disseminated Blastomyces dermatitidis Infection as Hip Pain in a Young AdultA Case Report
Joshua C. Hamann, MD1; Kevin Marberry, MD1
1 Missouri Sports Medicine, Department of Orthopaedic Surgery, University of Missouri, 213 McHaney Hall, One Hospital Drive, Columbia, MO 65212. E-mail address for K. Marberry: marberryk@health.missouri.edu
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Investigation performed at Missouri Sports Medicine, Department of Orthopaedic Surgery, University of Missouri at Columbia, Columbia, Missouri

Copyright ©2010 American Society for Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 Feb 01;92(2):469-472. doi: 10.2106/JBJS.I.00212
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In young, active patients, the common causes of hip pain are multiple and can include muscle strain, contusion, acetabular labral tear, osteochondral injury, sports hernia, snapping hip, proximal femoral stress fracture, and spinal abnormalities1-3. In most patients, an initial trial of nonoperative management is instituted. If pain persists or is of an unusual presentation, a more extensive diagnostic workup may be used. A thorough clinical evaluation can expedite the diagnosis of uncommon conditions of the musculoskeletal system, and the diagnostic evaluation may include magnetic resonance imaging of the pelvis and hip to evaluate the integrity of the periarticular structures. The case of the patient in the present report illustrates an unusual presentation of disseminated Blastomyces dermatitidis infection causing hip pain that was diagnosed with magnetic resonance imaging and was successfully treated through a multidisciplinary approach. The parents of the patient were informed that data concerning the case would be submitted for publication, and they consented.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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