2017, Volume 3 Issue 4
Wind-swept pelvis in poncet’s disease: A rare case report
Author(s): Dr. Chaitanya Krishna, Dr. Rakesh Kumar Gupta and Dr. Raj Singh
Abstract: Introduction: Windswept pelvis is a rare feature seen in Poncet’s Disease. This rare entity is found in cases with long standing disease. One hip is flexed, adducted and internal rotated while the contra lateral hip is flexed, abducted and external Rotated. Windswept hip deformity may occur in association with hip dislocation and scoliosis. Children with cerebral palsy (CP) exhibit spasticity, muscle weakness, and immobility, in combination with an inability to deal with the effects of gravity. Thus, these children are at risk of developing muscle contractures, hip dislocation, windswept hip deformity (WS), and scoliosis, either in isolation or in combination.
Case Report: A 14 year old female patient started having pain over Right hip with gradual restriction of movements. . Right hip was fixed in 30 degree of flexion, 20 degree adduction and 25 degree of internal rotation. . Hip MRI was done which showed hyper intensity in superolateral portion of femoral head and corresponding part of acetabulum, ilio-psoas involvement. CRP was positive with ESR- 32mm/hr at the start of disease 1 year back. ASO titre <200, anti CCP 12.5 ( equivocal), RA factor – negative, Hb- 9, TLC – 10,000 . . Broncho-alveolar lavage was done after which AFB smear, Cytology and Gene Expert was done and confirmed the diagnosis of Pulmonary TB with Rifampin sensitive. Montoux Test was done which was positive with 14 mm induration.Anti TB Cat I DOTS was started with bilateral surface traction. Now the patient is bearing weight with gradual recovery of painless joint motion of all the joint. She can now bear weight and can walk comfortably.
Conclusion: Poncet’s disease is a diagnosis of exclusion, and differential diagnosis should be kept in mind; whenever joint involvement is seen with the presence of Tubercular foci elsewhere in the body.