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A 17 years old female patient presented to PMR OPD with fixed flexion deformity of left hip and knee and cachexia. Five years back a severe pain was suddenly developed in her left knee and thigh which was investigated for juvenile inflammatory arthropathy and rheumatic arthritis. At that time all the serological markers (ANA, RF, ASO titre) and x-ray of knee were normal. Subsequently left hip pain and restricted ROM were developed which made it clear that the knee pain was actually referred from hip. A plain x-ray of hip was done to rule out Perthe’s disease which was reported as avascular necrosis of femur. When the patient was examined at PMR OPD, a CT scan of hip, routine hemogram, CXR, Manteux test was advised considering a provisional diagnosis of infective pathology like TB hip with a differential of neoplaia in or around hip keeping in mind about cachexia and weight loss. Surprisingly CT scan showed a big mass originating from glutei muscles evading back of the thigh and even left sphincter ani muscle. Fortunately patient was continent at that time. Interestingly the pathological report suggested a relatively rare diagnosis which practically made the patient bedridden with commonly featured fixed flexion deformity.

A Patient with Fixed Flexion Deformity of Hip and Knee