Osteitis in the Course of Pyodema Gangrenosum. Case Raport.

We present the case of a male patient admitted to the Department of Orthopaedics and Musculoskeletal Traumatology, Medical University of Silesia (MUS) in Katowice, due to a right hindfoot abscess with calcaneal infiltration and pain in the forehead and the back, with evidence of local inflammation. The patient had a history of ulcerative colitis and sclerosing cholangitis was suspected. During the hospital stay, the patient underwent calcaneal CT, surgery (resection of an inflammatory focus) and MRI of the thoracic and lumbosacral spine, which revealed inflamed spinous processes of the Th10, Th11 and Th12 vertebrae. Numerous cultures and histo-pathological examinations were performed. Specialist consultations were obtained. The differential diagnosis included myeloproliferative and lymphoproliferative processes as well as skin and soft tissue neoplasms. The clinical presentation and examination results led to a diagnosis of pyoderma gangrenosum and the patient was referred to the Department of Internal Medicine and Rheumatology of the MUS to undergo further treatment.