Korean J Pediatr Infect Dis.  1997 Nov;4(2):210-217. 10.14776/kjpid.1997.4.2.210.

Diagnostic Methods Used in the Bone Infections in Children

Affiliations
  • 1Department of Pediatrics College of Medicine, Yeungnam University, Daegu, Korea.
  • 2Dong Kang Hospital, Ulsan, Korea.

Abstract

PURPOSE
To prevent residual physical disability and chronic infection, prompt diagnosis and adequate treatment are important in the skeletal infections in children. Although radioisotope scanning is known as the method of choice for early diagnosis of bone infection, we conducted a study on twenty nine children who had skeletal infections to reevaluate the most appropriate way in diagnosis and management.
METHODS
A retrospective study was conducted on twenty nine children, who were admitted to the departments of Pediatrics and Orthopedic Surgery and who had acute osteomyelitis or septic arthritis, through review of medical records, radiologic & radioisotope study results. Their diagnoses were confirmed by bacteriologic cultures on the aspirated specimens from suspected bony lesions.
RESULTS
1) Among twenty nine patients, there were 6 infants including 5 newborn infants, and 23 children were aged between 1 and 15 years. Male to female ratio was 1.4 to 1. 2) Point tenderness was noted in all cases, and the common physical signs were swelling, limitation of motion, fever and local heat in the order of frequency. 3) Fifty two percents of the patients were diagnosed within a week after onset of symptoms and all cases were within 15 days. 4) Leukocytosis was noted in only 58.6% of cases but erythrocyte sedimentation rate was increased in all cases except only one case. Staphylococcus aureus was revealed as the most common etiologic agent. 5) Radioisotope scans showed hot uptake in five of six cases(83.3%) who had no abnormal finding on plain skeletal radiolograms.
CONCLUSIONS
Although radioisotope scan and MRI are helpful in early diagnosis before radiologic finding was detected on plain X-ray film, the antimicrobial therapy can be started after bacteriologic study of the aspirated specimens from the suspected skeletal lesions if skeletal infection is highly suspected clinically.

Keyword

Bone infection; Osteomyelitis; Arthritis; Diagnosis; Children

MeSH Terms

Arthritis
Arthritis, Infectious
Blood Sedimentation
Child*
Diagnosis
Early Diagnosis
Female
Fever
Hot Temperature
Humans
Infant
Infant, Newborn
Leukocytosis
Magnetic Resonance Imaging
Male
Medical Records
Methods*
Orthopedics
Osteomyelitis
Pediatrics
Radionuclide Imaging
Retrospective Studies
Staphylococcus aureus
X-Ray Film
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