Iliacus Muscle Hematoma an Unusual Presentation in Dengue Haemorrhagic Fever

A 40-year-old female presented to our emergency room (ER) with chief complaints of severe right-sided groin pain radiating to the medial aspect of her thigh and leg, the pain was continuous, gradually progressive and exaggerated by standing up straight. On examination, the skin appeared normal, with tenderness on palpation in the inguinal region and severe pain on flexion of the right thigh. All the distal pulses were palpable and the neurological examination was normal. She had a history of dengue haemorrhagic fever (NS1 positive) which started 6 days back and ended 2 days before the onset of pain. During the fever lowest platelet count was 34,000 cells/mm3 but now platelet count is 130,000 cells/mm3. On magnetic resonance imaging, screening of the whole spine and pelvis and hips, sagittal and coronal view of bilateral iliacus muscles appeared bulky with complex signal intensities on T2-weighted sequences suspicious of haematoma formation was seen [Figures 1 and 2, respectively]. The patient was managed conservatively and her pain and movement started improving after 10–12 days and completely improved after 2 months.Figure 1: Image showing iliac haematoma. Arrow points to the collection of blood localised to the iliacus muscle following dengue hemorrhagic feverFigure 2: Coronal section of magnetic resonance imaging highlighting muscle haematoma. Arrow points to the collection of blood localised to the iliacus muscle following dengue hemorrhagic feverDeclaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that her name and initials will not be published and due efforts will be made to conceal her identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.