Misconceptions about childhood acute osteomyelitis

Stephen, Raviraj Ferdinand; Benson, Michael J.; Nade, Sydney

doi:10.1007/s11832-012-0435-x

Cited by 21 publications

(17 citation statements)

References 20 publications

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“…The gaps in the metaphyseal vessels allow bacteria to escape from the bloodstream into the medullary cavity. In flat bones, the equivalent regions where infection tends to originate are the bony-cartilaginous junctions (12).…”

Section: Haematogenous Spreadmentioning

confidence: 99%

“…This may result in slipped epiphyses, growth impairment and joint destruction. In children older than 18 months of age, the growth plate ossifies and forms a barrier between the metaphysis and epiphysis, limiting the spread of infection from the metaphysis (12). In adulthood, the growth plate is reabsorbed, removing the barrier between the metaphyseal and epiphyseal vessels.…”

Section: Intraosseous Vascular Anatomymentioning

confidence: 99%

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The imaging of osteomyelitis

Lee

Sadigh

Mankad³

et al. 2016

Quant. Imaging Med. Surg.

279

221

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Osteomyelitis is an important cause of morbidity and mortality in children and adults. Imaging plays a crucial role in establishing a timely diagnosis and guiding early management, with the aim of reducing long-term complications. Recognition of the imaging features of osteomyelitis requires a good understanding of its pathogenesis. In this review, the key imaging findings in osteomyelitis are correlated with the underlying pathological processes. There is a particular emphasis on magnetic resonance imaging (MRI), which is the best available imaging modality owing to its high sensitivity for detecting early osteomyelitis, excellent anatomical detail and superior soft tissue resolution. However, other modalities such as nuclear medicine and computed tomography (CT) are also useful in many clinical contexts, and will also be described in this review.

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Section: Haematogenous Spreadmentioning

confidence: 99%

Section: Intraosseous Vascular Anatomymentioning

confidence: 99%

The imaging of osteomyelitis

Lee

Sadigh

Mankad³

et al. 2016

Quant. Imaging Med. Surg.

279

221

View full text Add to dashboard Cite

show abstract

“…The spread of a subperiosteal metaphyseal spongiosa contains abundant blood vessels with leaky endothelium and sluggish flow that end in capillary loops (13). More recent research has found that these vessels actually are terminal and that bacteria lodge at the junction between the physis and the metaphysis (16). The periosteum also is highly vascular in the child, but it is unclear whether it can be the site of origin of infection (17).…”

Section: Definition and Epidemiologymentioning

confidence: 99%

Hematogenous Osteomyelitis in Infants and Children: Imaging of a Changing Disease

Jaramillo¹,

Dormans²,

Delgado³

et al. 2017

Radiology

144

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In children, hematogenous osteomyelitis is an infection that primarily affects the most vascularized regions of the growing skeleton. The disease has increased in frequency, virulence, and degree of soft-tissue involvement. The change in clinical manifestations and management over the past 2 decades should be reflected in the current imaging approach to the disease. Imaging of infection must depict the location of a single focus or of multiple foci of involvement and the presence of drainable collections. This review provides an overview of the imaging implications directed by the changing epidemiology, the newer insights of anatomy and pathophysiology, the imaging characteristics with emphasis on specific locations and disease complications, and the differential diagnosis considerations. In addition, basic imaging guidelines for appropriate extent of area to image based on patient age are provided. RSNA, 2017.

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“…The likely pathogenesis of acute hematogenous osteomyelitis in children is the simultaneous occurrence of occult bacteremia and an anatomic susceptibility to bacterial invasion of the wellvascularized metaphysis (most often of the long-bones) in children. [1][2][3][4] Between 15% and 50% of osteoarticular infections involved both the joint and the bone (Fig. 1).…”

mentioning

confidence: 99%