An Unusual Presentation of Hip Pain in a Patient with Known Hyper-IgE Syndrome and Multiple Calcified Pelvic Apophyses

INTRODUCTION: Hyper-IgE syndrome (HIES) is a relatively rare condition which, from childhood, renders patients susceptible to infection. Typically patients with HIES can develop various orthopaedic manifestations of this disease, namely scoliosis, pathological fractures, osteoporosis, and potentially septic arthritis. CASE REPORT: We present the case of WJ, a 44-year old patient with known HIES(since the age of 11) and a 7-week history of left hip pain. We discuss the clinical presentation and the curveballs which came our way when investigating this patient and how we overcame them.We also demonstrate a very interesting pelvic radiograph from this patient which shows multiple sites of calcified apophyses. Something which is first unexpected in such patients and second something not previously reported in the literature. CONCLUSION: Several issues and conundrums can present themselves when dealing with patients known to have HIES. We demonstrate how we managed such a patient and maintained a high level of suspicion in such patient.