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Osteomyelitis of the patella
1Department of Pediatric Orthopaedics, Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
Insights
Patellar osteomyelitis, a rare childhood bone infection, often presents with delayed diagnosis due to varied symptoms. Prompt treatment, similar to other osteomyelitis cases, leads to favorable outcomes for children.
Area of Science:
- Pediatric Orthopedics
- Infectious Diseases
- Radiology
Background:
- Osteomyelitis of the patella is a rare pediatric infection.
- Diagnosis is often delayed due to its uncommon nature and variable presentation.
- It can mimic other conditions like septic arthritis or bursitis.
Purpose of the Study:
- To highlight the diagnostic challenges of patellar osteomyelitis in children.
- To outline the clinical presentation and diagnostic considerations.
- To emphasize appropriate treatment and expected outcomes.
Main Methods:
- Review of clinical presentations of pediatric patellar osteomyelitis.
- Analysis of diagnostic delays and challenges.
- Comparison of treatment protocols with other osteomyelitis sites.
Main Results:
- Patellar osteomyelitis presents with diverse symptoms, ranging from acute systemic signs to insidious local findings.
- Delayed diagnosis is common, necessitating a high index of suspicion.
- Standard osteomyelitis treatment is effective.
Conclusions:
- Early recognition of patellar osteomyelitis is crucial despite its rarity.
- Consideration in cases of persistent knee pain, swelling, or treatment-resistant knee infections.
- Favorable functional outcomes are expected in children with appropriate management.
Abstract:
Osteomyelitis of the patella is an uncommon infection that is primarily a disease of childhood. The diagnosis frequently is delayed because of its rarity and variable presentation, which may be acute with systemic signs or insidious with mild local signs. The diagnosis should be considered in patients with persistent peripatellar pain and swelling, cellulitis, septic prepatellar bursitis, and septic arthritis of the knee that does not respond to standard treatment. Treatment is identical to the treatment of osteomyelitis at other locations. The outcome is favorable in the child regarding range of motion and activity, although there may be persistent changes radiographically.