Is the emergency MRI protocol for acute pediatric osteoarticular infection a luxury or an absolute priority?

Valisena, Silvia; De Marco, Giacomo; Cochard, Blaise; Di Laura Frattura, Giorgio; Bazin, Ludmilla; Vazquez, Oscar; Steiger, Christina; Dayer, Romain; Ceroni, Dimitri

doi:10.3389/fped.2023.1328870

Cited by 1 publication

(1 citation statement)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This was also not observed on preoperative ultrasound, which remained unreliable due to being performed by an inexperienced resident in an emergency setting. In this context, the use of emergency magnetic resonance imagery protocol for pediatric osteoarticular infection could be very useful for accelerate the process, abstain from sedation and enhance the quality of images without the need for contrast ( 15 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Atypical acute compartment syndrome of the forearm in a child following minor trauma with consecutive osteomyelitis

Everaert,

Delafontaine,

Juanos Cabanas

et al. 2024

Front. Surg.

View full text Add to dashboard Cite

IntroductionForearm compartment syndrome (CS) in children is above all a clinical diagnosis whose main cause is traumatic. However, rarer causes such as infection can alter its clinical presentation.Clinical caseAn 8-year-old boy has been seen in the emergency department complaining of severe forearm pain under a splint in a mild traumatic context. The previous radiological imaging examination three days before had not revealed any fractures. On admission, he presented with major signs of skin inflammation, loss of mobility, paresthesia and a significant biological inflammatory syndrome. The acute CS diagnosis has been made and was treated, but its atypical presentation raised a series of etiological hypotheses, in particular infectious, even if it remains rare. Complementary imaging examinations confirmed the presence of osteomyelitis of the distal radius as well as an occult Salter-Harris II fracture.DiscussionBeyond the classic “five P's of CS” -pain, paresthesia, paralysis, pallor and pulselessness-, CS's clinical presentations are multiple, especially in pediatric patients. In children, severe pain and increasing analgesic requirement must be indicators of a CS. We hypothesize that this patient sustained a nondisplaced Salter-Harris II fracture with a hematoma colonized by hematogenous osteomyelitis explaining its initial clinical presentation.ConclusionHematogenous osteomyelitis complicated by CS is rare and may be accompanied by a traumatic history. It's atypical presentation in pediatric patients requires vigilance and prompt diagnosis given the disastrous and irreversible complications.

show abstract

Section: Discussionmentioning

confidence: 99%