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Diaphyseal primary subacute osteomyelitis in children
E B Hoffman1, J D de Beer, G Keys
1Red Cross Children's Hospital, Rondebosch, Cape Town, South Africa.
Journal of Pediatric Orthopedics
|March 1, 1990
Summary
Subacute osteomyelitis in children can mimic bone tumors on X-rays. Early diagnosis and cloxacillin treatment led to complete healing in all six reported cases.
Area of Science:
- Pediatric Orthopedics
- Pediatric Infectious Diseases
- Pediatric Radiology
Background:
- Subacute osteomyelitis presents diagnostic challenges, particularly in differentiating it from malignant bone tumors.
- Radiographic findings like linear periosteal reactions can be misleading, mimicking neoplastic processes.
Purpose of the Study:
- To report on six cases of subacute diaphyseal osteomyelitis in children.
- To highlight the diagnostic similarities between subacute osteomyelitis and round cell bone tumors.
- To evaluate the treatment and outcomes of subacute osteomyelitis.
Main Methods:
- Retrospective case series of six pediatric patients treated between 1985-1987.
- Clinical presentation, radiographic findings, and histological diagnoses were reviewed.
- Treatment involved cloxacillin, and outcomes were assessed radiographically.
Main Results:
- All six patients presented with subacute osteomyelitis of at least 2 weeks' duration.
- Radiographic findings included linear or laminated periosteal reactions, indistinguishable from bone tumors.
- Histological confirmation of osteomyelitis was achieved in all cases.
- Staphylococcus aureus was identified in two patients.
- All patients achieved complete healing with cloxacillin treatment.
- Radiographic resolution was observed within six months.
Conclusions:
- Subacute osteomyelitis in children can present with radiographic features mimicking bone tumors.
- Prompt diagnosis and appropriate antibiotic therapy (cloxacillin) are effective for treating subacute osteomyelitis.
- Early intervention leads to favorable outcomes and radiographic resolution.