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Osteomyelitis in infants and children

  • Pediatric
  • Published:
European Radiology Supplements

Abstract

Infection of the pediatric skeletal system is a dramatic diagnostic and therapeutic challenge. The consequences of a missed diagnosis could lead to long-lasting functional sequelae. This disease has multiple aspects according to the clinical presentation and evolution, the causative microorganism, the site of infection, and, finally, the patient's age and immunological status. The choice of the most appropriate imaging modality according to the clinical presentation is very important to assess the diagnosis, the extent of the disease, and to obtain the causative germ when needed; thus, plain films, ultrasound, nuclear medicine, computed tomography, and MR imaging are discussed, each of them having pros and cons. This multimodality approach of the musculoskeletal infections is mandatory to guide surgery, to deliver an appropriate antibiotic therapy, and to reduce the rate of long-term functional sequelae.

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References

  1. Gold R (1991) Diagnosis of osteomyelitis. Pediatr Rev 12:292-297

    CAS  PubMed  Google Scholar 

  2. Boutin R, Resnick D (1998) The SAPHO syndrome: an evolving concept for unifying several idiopathic disorders of bone and skin. Am J Roentgenol 170:585-591

    CAS  PubMed  Google Scholar 

  3. Jaramillo D, Treves S, Kasser J et al. (1995) Osteomyelitis and septic arthritis in children: appropriate use of imaging to guide treatment. Am J Roentgenol 165:399-403

    CAS  PubMed  Google Scholar 

  4. Resnick D (2002) Osteomyelitis, septic arthirtis and soft tissue infection: mechanisms and situations. In: Resnick D (ed) Bone and joint disorders. Saunders, Philadelphia, pp 2377-2480

  5. Resnick D (2002) Osteomyelitis, septic arthirtis and soft tissue infection: organisms. In: Resnick D (ed) Bone and joint disorders. Saunders, Philadelphia, pp 2510-2624

  6. Oudjhane K, Azouz E (2001) Imaging of osteomyelitis in children. Radiol Clin North Am 39:251-266

    CAS  PubMed  Google Scholar 

  7. Abernathy L, Lee Y, Cole W (1993) Ultrasound localisation of subperiosteal abscesses in children with late-acute osteomyelitis. J Pediatr Orthop 13:766

    PubMed  Google Scholar 

  8. Hoffer F, Emans J (1998) Percutaneous drainage of subperiosteal abscess: a potential treatment for osteomyelitis. Pediatr Radiol 28:879-881

    Google Scholar 

  9. Kaiser S, Rosenborg M (1994) Early detection of subperiosteal abscesses by ultrasonography. Pediatr Radiol 24:336-339

    CAS  PubMed  Google Scholar 

  10. Howard C, Einhorn M, Dagan R et al. (1994) Fine needle biopsie to diagnose osteomyelitis. J Bone Joint Surg Br 76:311-314

    CAS  PubMed  Google Scholar 

  11. Howard C, Einhorn M, Dagan R, Nyska M (1995) Ultrasonic features of acute osteomyelitis. J Bone Joint Surg Br 77:663-664

    CAS  PubMed  Google Scholar 

  12. Turpin S, Lambert R (2001) Role of scintigrapy in musculoskeletal and spinal infections. Radiol Clin North Am 39:169-189

    CAS  PubMed  Google Scholar 

  13. Cohen M, Cory D, Kleiman M (1990) Magnetic resonance differenciation of acute and chronic osteomyelitis in children. Clin Radiol 41:53-56

    CAS  PubMed  Google Scholar 

  14. Gylis-Morin V (1998) MR imaging of pediatric musculo-skeletal inflammatory and infectious disorders. Magn Reson Imaging Clin North Am 6:537-559

    CAS  Google Scholar 

  15. Dangman B, Hoffer F, Rand F, Rourke E (1996) Osteomyelitis in children: gadolinium-enhanced MR imaging. Radiology 182:743-747

    Google Scholar 

  16. Delfaut E, Beltran J, Johnson G et al. (1999) Fat suppression in MR imaging: techniques and pitfalls. Radiographics 19:373-382

    PubMed  Google Scholar 

  17. Morrison W, Schweitzer M, Bock G et al. (1993) Diagnosis of osteomyelitis: utility of fat-supressed contrast-enhanced MR imaging. Radiology 189:251-257

    CAS  PubMed  Google Scholar 

  18. Resnick D (2002) Osteomyelitis, septic arthirtis and soft tissue infection: axial skeleton. In: Resnick D (ed) Bone and joint disorders. Saunders, Philadelphia, pp 2481-2509

  19. Mahboubi S, Morris MC (2001) Imaging of spinal infections in children. Radiol Clin North Am 39:215-222

    CAS  PubMed  Google Scholar 

  20. Andronikou S, Jadwat S, Douis H (2002) Patterns of disease on MRI in 53 children with tuberculous spondylitis and the role of gadolinium. Pediatr Radiol 32:798-805

    Article  PubMed  Google Scholar 

  21. Alexander C (1970) The aetiology of juvenile spondylo-arthritis (discitis). Clin Radiol 21:178-187

    CAS  PubMed  Google Scholar 

  22. Fischer G, Popich G, Sullivan D et al. (1978) Discitis: a prospective diagnostic analysis. Pediatrics 62:543-548

    CAS  PubMed  Google Scholar 

  23. Sadat-Ali M, Al-Umran K, Al-Habdan I, Al-Mulhim F (1998) Ultrasonography: Can it differenciate between vaso-occlusive crisis and acute osteomyelitis in sickle cell disease? J Pediatr Orthop 18:552-554

    Article  CAS  PubMed  Google Scholar 

  24. Cazaban B, Montagne J, Schmit P, Faurhc) C (1984) Troubles de la croissance des doigts: shc)quelles de purpura fulminans. Arch Fr Pediatr 41:61-62

    Google Scholar 

  25. Grier D, Feinstein K (1993) Osteomyelitis in hospitalized children with chickenpox: imaging findings in four cases. Am J Roentgenol 161:643-646

    CAS  Google Scholar 

  26. Mandell G, Contreras S, Conard K et al. (1998) Bone scintigraphy in the detection of chronic recurrent multifocal osteomyelitis. J Nucl Med 10:1778-1783

    Google Scholar 

  27. Schultz C, Holterhus P, Seidel A et al. (1999) Chronic recurrent multifocal osteomyelitis in children. Pediatr Infect Dis J 18:1008-1013

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Pierre Schmit.

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Schmit, P., Glorion, C. Osteomyelitis in infants and children. Eur Radiol Suppl 14, L44–L54 (2004). https://doi.org/10.1007/s00330-003-2031-4

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