Spondylodiscitis in children: a retrospective series

Area of Science:

• Pediatric Orthopedics
• Pediatric Infectious Diseases
• Pediatric Radiology

Background:

• Spondylodiscitis in children can be challenging to diagnose due to non-specific symptoms.
• Delayed diagnosis may lead to prolonged treatment and potential long-term complications.

Purpose of the Study:

• To review the clinical presentation, diagnostic methods, and treatment outcomes of pediatric spondylodiscitis.
• To evaluate the impact of diagnostic delays and the utility of imaging modalities.

Main Methods:

• Retrospective review of 16 pediatric patients diagnosed with spondylodiscitis between 2000 and 2007.
• Analysis of clinical presentation, diagnostic investigations (including plain radiography and ESR), treatment, and follow-up data.

Main Results:

• A mean diagnostic delay of 25 days was observed in younger children (<24 months).
• Common symptoms included refusal to walk/sit, fever, irritability, and limping; plain radiography was often non-diagnostic.
• Erythrocyte Sedimentation Rate (ESR) was useful for monitoring disease course; Staphylococcus aureus was the most common pathogen.
• Most children achieved clinical recovery, but older children (>24 months) showed radiological degenerative changes.

Conclusions:

• Pediatric spondylodiscitis frequently presents with a confusing clinical picture, resulting in delayed diagnosis.
• Early Magnetic Resonance Imaging (MRI) is recommended for children with atypical presentations to expedite treatment.
• While clinical recovery is common, long-term radiological consequences may occur, particularly in older children.