Pelvic-femoral osteomyelitis complicating Crohn's disease.

Osteomyelitis of the pelvic bones arises in Crohn's disease when enteric fistulas from the ileocolonic region allow extention of the anaerobic intestinal flora to the psoas region of the right hemipelvis. Bone destruction is usually an unexpected finding during roentgenographic evaluation of abdominal symptoms in young men with severe ileocecal disease. Suppressive therapy and previous abdominal surgery do not appear to be significant predisposing factors. Therapy requires dé-bridement, resection/saucerization, drainage, and appropriate antibiotic coverage.