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Published on: January 27, 2011
Osteomyelitis in children with sickle cell disease: early diagnosis with contrast-enhanced CT
J E Stark1, C M Glasier, R D Blasier
1Department of Radiology, University of Arkansas for Medical Sciences, Little Rock.
Insights
Computed tomography (CT) aids early osteomyelitis diagnosis in children with sickle cell disease, preventing delays and reducing complications. Prompt CT scans are crucial when symptoms mimic bone infarction.
Area of Science:
- Pediatric medicine
- Radiology
- Hematology
Background:
- Osteomyelitis diagnosis in sickle cell disease patients is challenging due to overlapping symptoms with bone infarction.
- Plain radiography may lack early characteristic findings.
- Radionuclide scans have shown variable diagnostic utility.
Purpose of the Study:
- To evaluate the role of computed tomography (CT) in the early diagnosis of osteomyelitis in children with sickle cell disease.
- To highlight the benefits of prompt CT imaging in managing this patient population.
Main Methods:
- Case study of two children with sickle cell disease and suspected osteomyelitis.
- Utilized computed tomography (CT) for diagnostic imaging.
- Compared diagnostic timelines and treatment outcomes based on imaging modality.
Main Results:
- One patient experienced delayed treatment due to reliance on initial radiographic findings.
- The other patient received prompt diagnosis and treatment following early CT scan identification of a subperiosteal abscess.
- CT imaging facilitated definitive diagnosis in equivocal cases.
Conclusions:
- Early computed tomography (CT) is a valuable tool for diagnosing osteomyelitis in children with sickle cell disease.
- Prompt CT can prevent diagnostic delays and associated morbidity in these patients.
- CT imaging can differentiate osteomyelitis from bone infarction when clinical presentations are similar.
Abstract:
Two children with sickle cell disease and osteomyelitis were treated. In one child, definitive treatment was delayed until computed tomography (CT) revealed a subperiosteal abscess. Early performance of CT in the other child resulted in prompt diagnosis and treatment. Before the appearance of the characteristic plain radiographic findings, diagnosis of osteomyelitis in patients with sickle cell disease can be difficult because the clinical manifestations of infarction and osteomyelitis can be similar. Radionuclide scans have yielded mixed results. In equivocal cases, early performance of CT can help establish the diagnosis of osteomyelitis to avoid significant morbidity.
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