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Childhood discitis in a regional children's hospital

Simon J Spencer1, Neil I L Wilson

  • 1Department of Orthopaedic Surgery, Royal Hospital for Sick Children, Dalnair Street, Yorkhill, Glasgow, UK. simon.spencer@nhs.net

Journal of Pediatric Orthopedics. Part B
|October 22, 2011
PubMed

Insights

Childhood discitis, a rare spinal infection, presents unusually with normal infection tests and gait changes. Diagnosis often requires MRI, but symptoms typically resolve with antibiotics without recurrence.

Area of Science:

  • Pediatric infectious diseases
  • Pediatric rheumatology
  • Pediatric orthopedics

Background:

  • Childhood discitis is a rare condition.
  • Its etiology (infective vs. inflammatory) remains unclear.
  • Diagnosis can be challenging due to non-specific symptoms.

Purpose of the Study:

  • To describe the clinical features, diagnosis, and management of childhood discitis.
  • To highlight diagnostic challenges and diagnostic criteria.
  • To report on treatment outcomes and recurrence rates.

Main Methods:

  • Retrospective review of a departmental database from 1990-2008.
  • Identification of 12 pediatric cases of discitis.
  • Analysis of clinical presentation, diagnostic methods, treatment, and outcomes.

Main Results:

  • A mean diagnostic delay of 22 days from symptom onset.
  • Common presentation includes altered gait with normal infection markers (temperature, white cell count, C-reactive protein, blood cultures).
  • Radiographic findings show loss of intervertebral disc height; symptoms resolved in a mean of 6.5 weeks with no recurrence.

Conclusions:

  • Childhood discitis exhibits unusual features, often presenting with normal inflammatory markers.
  • Magnetic resonance imaging (MRI) is crucial for diagnosis.
  • The condition appears to have a favorable prognosis with antibiotic treatment and no need for immobilization.

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