Arthrokatadysis from post-injection gluteal muscular fibrosis case report

BACKGROUND: Gluteal muscle contracture (GMC) is a clinical syndrome characterized by the contracture of gluteal muscles, iliotibial band (ITB), and related fascia. GMC is much more prevalent in China, which has been proven to be associated with repeated intramuscular injections into the buttocks and the subsequent fibrosis and contracture.Generally, GMC is manifested mild. Here, we reported a severe case with arthrokatadysis. CASE PRESENTATIONS: A 25-year old man received multiple intramuscular injections of penicillin in the buttock when he was diagnosed with acute tonsillitis at 6 years old. Since then, he was injected penicillin regularly in local hospital because of the repeated acute tonsillitis until he was in high school. When the patient was found by the physical education teacher to be running in a state of external rotation of both feet, he was suggested to go to the hospital for treatment and was initially diagnosed to have GMC. He complained of occasional pain and limited range of motion in the hip joints. X-ray showed a typical arthrokatadysis. After arthroscopic release of GMC, the patient recovered well. CONCLUSIONS: This is possibly the first reported case of arthrokatadysis that was caused by GMC after repeated intramuscular injections into the buttocks. Although the patient recovered well by arthroscopic surgical release of bilateral gluteus maximus contractures, GMC should be paid more attention and treated as early as possible.