Ewing’s sarcoma of the ilium mimicking inflammatory arthritis of the hip: a case report

INTRODUCTION: Ewing’s sarcoma is second most common primary malignant bone neoplasm in children and adolescents. We report a case of Ewing’s sarcoma of ilium in an 18-year-old female mimicking clinically and radiologically inflammatory arthritis of hip joint, a rare entity not mentioned in literature. CASE PRESENTATION: An 18-year-old girl presented with pain hip, limp and fever off and on. Patient had restricted range of motion, raised erythrocyte sedimentation rate, leucocytosis and radiograph showed reduced joint space. Magnetic resonance imaging pelvis revealed an altered marrow signal of acetabulum with a large soft tissue component. Histopathology revealed a malignant round cell tumor consistent with Ewing’s sarcoma. CONCLUSION: Classical clinical and radiological presentation of Ewing’s sarcoma of ilium may not be the rule. One should be highly suspicious of the disease even if there is no direct pointer to the disease as was encountered in our case.