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Updated: Apr 4, 2026

Quantifying Learning in Young Infants: Tracking Leg Actions During a Discovery-learning Task
Published on: June 1, 2015
An infant not moving her leg
Tal Berkowitz1, Deborah Young1
1Division of Pediatric Emergency Medicine, Department of Pediatrics, Emory University, Atlanta, GA.
Insights
A 4-week-old infant
Area of Science:
- Pediatric Infectious Diseases
- Pediatric Orthopedics
- Medical Imaging in Pediatrics
Background:
- Neonatal osteomyelitis is a serious condition that can lead to long-term complications if not diagnosed and treated promptly.
- Early diagnosis is crucial but can be challenging due to non-specific symptoms in infants.
Observation:
- A 4-week-old infant presented with non-specific symptoms including decreased movement of the left lower extremity and irritability.
- Initial X-rays were normal, delaying diagnosis.
- Repeat imaging revealed a subtle lucency, prompting further investigation.
Findings:
- Magnetic resonance imaging (MRI) confirmed distal tibial osteomyelitis with an ankle effusion.
- Group B Streptococcus was identified as the causative pathogen from bone cultures.
- The infant successfully completed 6 weeks of antibiotic therapy.
Implications:
- This case highlights the importance of considering osteomyelitis in infants with subtle or non-specific symptoms.
- Advanced imaging like MRI is critical for diagnosing pediatric bone infections when initial radiography is inconclusive.
- Prompt antibiotic treatment is essential for favorable outcomes in neonatal osteomyelitis.
Abstract:
A 4-week-old female infant presented to the emergency department (ED) due to a 1-week history of not moving her left lower extremity as well as crying during diaper changes. She had been seen 6 days prior at an ED, had normal x-rays, and was discharged home. The infant was afebrile and well appearing and had been feeding well all week. Laboratory tests in our department, including a complete blood count with differential and inflammatory markers, were all normal. Repeat x-rays showed a subtle distal tibial lucency, initially overlooked. The infant was admitted to the hospital and received a magnetic resonance imaging,which demonstrated distal tibial osteomyelitis with an accompanying ankle effusion. Cultures from the bone grew group B Streptococcus, and the infant received 6 weeks of antibiotic therapy.
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