Pelvic osteomyelitis in children

Abstract

Pelvic osteomyelitis is a rare disease that presents like many other common paediatric orthopaedic conditions. The diagnosis and management of the disease is often delayed and as a consequence this may contribute to increased morbidity in affected individuals. In an attempt to improve our diagnostic accuracy, 23 cases of pelvic osteomyelitis presenting to our tertiary referral centre between 1998 and 2006 were reviewed. Case notes were reviewed to examine clinical, pathological and radiological variables attributable to pelvic osteomyelitis, as well as subsequent management of the disease. Pelvic osteomyelitis was diagnosed on the basis of a positive bone and/or magnetic resonance scan. The presentation was associated with a limp and a history of non-weight bearing. The patients presented with an average temperature of 38.4 degrees C and pathology revealed an average erythrocyte sedimentation rate and C-reactive protein of 61.2 and 59.1, respectively. A child with a clinical picture including limping, fevers and raised inflammatory markers should be approached with a high index of suspicion of pelvic osteomyelitis. Seven patients in our series required surgical intervention for debridement and washout. Magnetic resonance imaging performed in the most recent cases was found to be a useful investigation in the diagnosis and management of pelvic osteomyelitis.

Pseudomonas Pelvic Osteomyelitis in a Healthy Child

“…However, clinicians should suspect this diagnosis especially in a school-aged child who presents with fever, pain, limp, and/or inability to bear weight (Table 1). [1][2][3][4][5][6][7][8][9] If the diagnosis is suspected, the initial non-invasive test to consider is a bone scan. Once confirmed, a biopsy with culture should be sent to direct antibiotic therapy.…”

Osteomielitis pélvica en una paciente de 15 años. Presentación de un caso

“…2 Además, no existen signos ni síntomas clínicos específicos que permitan descartar otras enfermedades infecciosas y ortopédicas. 5 En este artículo presentamos el caso de una paciente con osteomielitis pélvica que recibió el diagnóstico al mes de la manifestación de los síntomas iniciales.…”

Pelvic osteomyelitis: Three unusual cases with predominantly abdominal symptoms

“…1 Children usually present with a fever and limp or inability to weight bear. 2 Isolated abdominal symptoms are uncommon, accounting for 5% of pelvic osteomyelitis presentations. 3 We report three cases of paediatric osteomyelitis seen within a 6-month period with predominantly abdominal symptoms, presenting a diagnostic challenge.…”

“…Paediatric pelvic osteomyelitis is a rare entity and an initial presentation without limb symptoms is exceedingly uncommon. [1][2][3] As abdominal symptoms may precede limb symptoms in certain cases, the diagnosis should be considered when abdominal or other pelvic pathology is not apparent. MRI is the investigation of choice for pelvic osteomyelitis.…”