Multifocal rib osteomyelitis in children: a case report and literature review

Idrissa, Salahoudine; Tazi, Mohammed Fadl; Cherrabi, Hind; Abdoulaziz, Souley; Mahmoudi, Abdelhalim; Elmadi, Aziz; Khattala, Khalid; Bouabdallah, Youssef

doi:10.1093/jscr/rjx142

Cited by 6 publications

(9 citation statements)

References 10 publications

(15 reference statements)

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“…Along with a detailed history, physical exam and laboratory results, imaging plays an important role in the diagnosis of rib osteomyelitis. However, imaging findings in these children can be nonspecific and often mimic other pathologies, especially early in the course of infection [8,9].…”

Section: Introductionmentioning

confidence: 99%

Osteomyelitis of the ribs in children: a rare and potentially challenging diagnosis

et al. 2019

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BACKGROUND Rib osteomyelitis is rare in children and can mimic other pathologies. Imaging has a major role in the diagnosing rib osteomyelitis. OBJECTIVE To evaluate clinical presentation and imaging findings in children with rib osteomyelitis. MATERIALS AND METHODS We performed a retrospective (2009-2018) study on children with rib osteomyelitis verified by either positive culture or pathology. We excluded children with multifocal osteomyelitis or empyema necessitans. We reviewed medical charts for clinical, laboratory and pathology data, and treatment. All imaging modalities for rib abnormalities were evaluated for presence and location of osteomyelitis and abscess. We calculated descriptive statistics to compare patient demographics, clinical presentation and imaging findings. RESULTS The study group included 10 children (6 boys, 4 girls), with an average age of 7.3 years (range, 3 months to 15.9 years). The most common clinical presentations were fever (n=8) and pain (n=5). Eight children had elevated inflammatory indices (leukocytosis, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP]). Localized chest wall swelling was found initially in six children and later in two more children. Rib osteomyelitis was suspected on presentation in only two children. All children had chest radiographs. Rib lytic changes were found on only one chest radiograph, in two of the four ultrasound studies, and in four of eight CTs. Bone marrow signal abnormalities were seen in all eight MRIs. In nine children the osteomyelitis involved the costochondral junction. Six children had an associated abscess. Staphylococcus aureus was cultured in eight children. Osteomyelitis was diagnosed based on pathology in one child with negative cultures. CONCLUSION While rib osteomyelitis is rare, imaging findings of lytic changes at the costochondral junction combined with a history of fever, elevated inflammatory markers or localized softtissue swelling in the chest should raise suspicion for this disease.

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Section: Introductionmentioning

confidence: 99%

Osteomyelitis of the ribs in children: a rare and potentially challenging diagnosis

et al. 2019

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“… 19 The child is afebrile with no periosteal reaction of the ribs with soft tissue swelling, fistula, localized erythema, warmth, or swelling at the costochondral junction or posteriorly at the costovertebral angle, ruling out Caffey disease and osteomyelitis. 20 , 21 , 22 …”

Section: Questions/discussion Points Partmentioning

confidence: 99%

Educational Case: Osteogenesis imperfecta

2022

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“…Rib osteomyelitis in pediatric patients is rare, with less than 60 cases reported in the literature. 1 , 3 It has been described in association with tuberculosis, 4 via hematogenous spread, 5 and as a sequela of child abuse. 6 Our case illustrates that uncommon and rare causes of fever of unknown origin, such as osteomyelitis, should be considered in the evaluation of pediatric patients presenting to the ED.…”

Section: Discussionmentioning

confidence: 99%

Rib Osteomyelitis in a Pediatric Patient: Case Report and Review of the Literature

Nibley¹,

Kraus

2018

Clinical Practice and Cases in Emergency Medicine

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We present a case report and review of the literature of rib osteomyelitis in a pediatric patient presenting to the emergency department (ED) with fever and increased work of breathing. The patient was seen on a return visit to the ED after discharge with presumed viral illness approximately 12 hours prior. On the second ED visit, there was concern for occult bacteremia, and work-up ultimately revealed a subperiosteal abscess with rib osteomyelitis, a rare etiology for fever in the pediatric patient. The patient was treated with antibiotics, had surgical debridement, and fully recovered.

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Multifocal rib osteomyelitis in children: a case report and literature review

Cited by 6 publications

References 10 publications

Osteomyelitis of the ribs in children: a rare and potentially challenging diagnosis

Osteomyelitis of the ribs in children: a rare and potentially challenging diagnosis

Educational Case: Osteogenesis imperfecta

Rib Osteomyelitis in a Pediatric Patient: Case Report and Review of the Literature

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