Diaphyseal Primary Subacute Osteomyelitis in Children

Hoffman, EB; Beer, Justin de; Keys, Graham W.; Anderson, Peter J.

doi:10.1097/01241398-199003000-00024

Cited by 23 publications

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“…[5][6][7][8][9][10][11][12][13][14][15][16] Almost one third of our subjects were under 2 years of age, although the median age was similar to those previously reported in all series 5-8,10-16 except one. [5][6][7][8][9][10][11][12][13][14][15][16] Almost one third of our subjects were under 2 years of age, although the median age was similar to those previously reported in all series 5-8,10-16 except one.…”

Section: Discussionsupporting

confidence: 87%

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Retrospective Assessment of Subacute or Chronic Osteomyelitis in Children and Young Adults

Auh

Binns

Katz

2004

Clin Pediatr (Phila)

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To identify factors associated with and to describe treatment outcomes of pediatric subacute or chronic osteomyelitis (S/CO), we retrospectively identified 52 patients with S/CO from January 1994 to November 1999 seen at a large pediatric hospital infectious disease clinic. S/CO was defined by the following: >10 days of clinical symptoms; radiographic, surgical, or pathologic changes consistent with S/CO; or relapse of prior osteomyelitis. Of these patients 63% were male, median age 9 years. Bones involved included vertebra (19% of subjects), femur (17%), finger (12%), humerus (10%), and tibia (8%). Sixty-five percent had at least 1 risk factor (most commonly hardware, neurologic disease or preceding trauma, sepsis, or surgery). Blood, bone, or wound aspirate cultures were positive in 67%, most commonly for Staphylococcus aureus. Erythrocyte sedimentation rate (ESR) was elevated in 88% of 41 patients at the time of diagnosis. Intravenous antibiotics were given for a median of 6 weeks and oral antibiotics for a median of 4.5 months. One child had a complication. In conclusion, consideration of S/CO should be high when predisposing factors are present. ESR may be useful for determining effectiveness and duration of therapy. With prolonged antibiotic therapy nearly all patients demonstrated resolution of disease.

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Section: Discussionsupporting

confidence: 87%

“…5,6,[9][10][11]13,15 The majority of these patients had a neurologic disorder (most commonly meningomyelocele) or Harrington rods in place. About one fifth of our patients had vertebral S/CO, a site not reported in most previous series of S/CO.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Assessment of Subacute or Chronic Osteomyelitis in Children and Young Adults

Auh

Binns

Katz

2004

Clin Pediatr (Phila)

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“…This differential diagnosis has been emphasised. 6,14,23 Primary subacute osteomyelitis commonly involves a single bone, and Cole 22 emphasised that it is distinct from chronic multifocal osteomyelitis of which the recurrent type and the SAPHO syndrome are the forms which it may resemble. These conditions are usually recurrent and may be associated with skin infections.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis is usually confirmed by histological examination which shows an inflammatory component with scattered lymphocytes, plasma cells and granulation tissue. 2,4,6,7,14 Staphylococcus aureus is regarded as the causative organism by most authors. It is, however, difficult to identify and was positively isolated in only 29% of our patients, which is similar to other reports.…”

Section: Discussionmentioning

confidence: 99%

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Primary subacute haematogenous osteomyelitis in children

Rasool

2001

The Journal of Bone and Joint Surgery

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Between 1990 and 1998 we saw 21 children with primary subacute haematogenous osteomyelitis. Pain, swelling and a limp had been present for two to 12 weeks with little functional impairment. Laboratory tests were non-contributory. The lesions were classified radiologically into metaphyseal, diaphyseal, epiphyseal and vertebral. There were 24 sites involved, with most (20) being in the tibia; 17 lesions were in the diaphysis, five in the metaphysis and two in the epiphysis. The diagnosis was confirmed histologically in all cases. Staphylococcus aureus was cultured in six patients. Healing occurred in all patients after treatment with antibiotics for six weeks and radiological improvement was seen after three to six months. Subacute osteomyelitis develops as a result of increased host resistance and decreased bacterial virulence. The radiological features can mimic various benign or malignant bone tumours and non-pyogenic infections. Histological confirmation is necessary to avoid a delay in diagnosis.

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Imaging Approach to Musculoskeletal Infections

Reinus

2009

Diagnostic Imaging of Musculoskeletal Diseases

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Diaphyseal Primary Subacute Osteomyelitis in Children

Cited by 23 publications

References 0 publications

Retrospective Assessment of Subacute or Chronic Osteomyelitis in Children and Young Adults

Retrospective Assessment of Subacute or Chronic Osteomyelitis in Children and Young Adults

Primary subacute haematogenous osteomyelitis in children

Imaging Approach to Musculoskeletal Infections

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