Osteomyelitis und purulente Arthritis. Vergleichsstudie mit besonderer Berücksichtigung von Ätiologie und Heilung

Abstract

We analysed the records of 44 paediatric cases of acute haematogenous osteomyelitis (age 0-14 years) and 25 cases of purulent arthritis (age 0-13 years). The annual incidences were 4.5 and less than two per 100,000 children, respectively. Bacteriologic diagnosis was achieved in 82% of the acute haematogenous osteomyelitis cases and in 40% of the acute purulent arthritis cases. Staphylococcus aureus was responsible for 70% of the proven acute haematogenous osteomyelitis and acute purulent arthritis cases combined, followed by streptococci (20%) and Haemophilus influenzae (7%), which caused only acute purulent arthritis. Acute haematogenous osteomyelitis was localized in the femur in 41% of the cases and acute purulent arthritis in the knee joint in 76%. Surgery (in most cases drilling, fenestration or arthrotomy) was performed on 82% of the acute haematogenous osteomyelitis and on 32% of the acute purulent arthritis patients. Although six of the acute haematogenous osteomyelitis patients (but none of the acute purulent arthritis patients) underwent surgery for a second time, permanent damage, which was functionally non-significant, developed in only 14%. No sequelae were found in the acute purulent arthritis group. The average duration of antimicrobial therapy was 44 days in the acute haematogenous osteomyelitis group and 29 days in the acute purulent arthritis group. The prognosis for the children was similar, irrespective of whether the drugs used were staphylococcal penicillins, ampicillin, lincomycin or clindamycin.

Procalcitonin as a Diagnostic Aid in Osteomyelitis and Septic Arthritis

“…19 The actual cause of acute purulent arthritis remains unclear in as many as two thirds of the cases and is comparable with the findings in our series. 21,22 Our small group of patients precludes us to identify whether PCT is a good tool in the diagnosis of septic arthritis, and more extensive research is needed. Although we did not have any cultures obtained from the site of bone infection, our diagnosis of osteomyelitis was based on skeletal scintigraphy and that it is a well-established fact that this method has a sensitivity and specificity that exceed 90%.…”

The accuracy of different imaging techniques in diagnosis of acute hematogenous osteomyelitis

“…There are different diagnostic criteria for AHO in the medical literature (8,10). In this study, as well as in daily work, we have used our own criteria (3,11,12), which are quite similar to those described in references.…”

Role of MRI in detecting early physeal changes due to acute osteoarticular infection around the knee joint: a pilot study

“…Of these, 15 children could be followed up for six months after disease onset. The initial diagnosis of acute osteomyelitis had been made using Peltola and Vahvanen's criteria [8] and of septic arthritis using Morrey et al's criteria [6]; those not meeting the criteria were excluded from the study. Of the 15 children, nine were boys and six were girls.…”