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[Pseudotumoral subacute osteomyelitis: a series of 41 children]
E Chau1, R Kohler, J Cottalorda
1Service de chirurgie pédiatrique (Pavillon Tbis), Hôpital E. Herriot, 69437 Lyon Cedex 03.
Insights
Subacute osteomyelitis in children, characterized by bone geodes and pain without fever, is a distinct condition. Surgical intervention, often involving scraping, aids in diagnosis and recovery.
Area of Science:
- Pediatric Orthopedics
- Infectious Diseases
Context:
- Subacute osteomyelitis is a challenging diagnosis in pediatric patients.
- Distinguishing it from benign bone tumors is crucial for appropriate management.
Purpose:
- To confirm subacute osteomyelitis as a distinct clinical entity in children.
- To delineate the characteristic features of this condition.
Summary:
- Pain without fever is the primary symptom.
- Elevated erythrocyte sedimentation rate and metaphyseal/epiphyseal geodes on X-rays are key findings.
- Surgical scraping allows microbial identification (Staphylococcus aureus common) in 50% of cases.
Impact:
- Highlights the frequency of subacute osteomyelitis presenting as cystic bone lesions.
- Emphasizes the need for considering this diagnosis in pediatric long bone imaging findings.
Purpose Of The Study:
To confirm that subacute osteomyelitis in children is a real entity, and give the main characteristics of this disease
Material And Methods:
We reviewed 41 cases as well as the litterature.
Results:
Pain without fever was the only constant symptom. The erythrocyte sedimentation rate was increased slightly. XRays were the most important investigation, showing a geode in the metaphysis or more rarely in the epiphysis evoking a benign bone tumor in a child.
Discussion:
The treatment was most often surgical: scraping permits the isolation of the microbe in 50 per cent of cases (staphylococcus most often) and usualy leady to recovery.
Conclusion:
This form of osteomyelitis is relatively frequent and must be discussed in front of a cystic tumoral image of the child's long bone.