[Osteomyelitis of the talus in a limping child]

Haematogenous osteomyelitis of the talus is a rare cause of limping in children. Due to the slow onset and atypical pattern of symptoms, it is difficult to diagnose. This can result in delays in the provision of adequate treatment.

A 3-year old girl was examined in the outpatient ward for pain in the right leg and limping. A diagnosis of coxitis fugax was suspected initially. Supplemental laboratory testing, conventional roentgenograms and bone scintigraphy however, showed a haematogenous osteomyelitis of the talus. The patient was treated with flucloxacillin. She was symptom-free four months after the first outpatient visit, with full recovery of function in her right ankle and foot.

Haematogenous osteomyelitis of the talus is rare in children. The diagnosis is often missed because symptoms are often subtle in the early phase. It is important to choose imaging techniques carefully because treatment with antibiotics is sufficient when this type of osteomyelitis is detected at an early stage.