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Physeal separation in pediatric osteomyelitis.
Mary R Wyers1, Jonathan D Samet2, Leena B Mithal3
1Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Chicago, IL, 60611, USA. mwyers@luriechildrens.org.
Pediatric Radiology
|May 17, 2019
Summary
Acute pediatric osteomyelitis can cause physeal separation, mimicking trauma. Recognizing this bone infection finding on radiographs is crucial for accurate diagnosis in children.
Area of Science:
- Pediatric Orthopedics
- Pediatric Infectious Diseases
- Pediatric Radiology
Background:
- Acute osteomyelitis in children is typically hematogenous.
- Diagnosis often involves magnetic resonance imaging (MRI) showing marrow signal changes and gadolinium enhancement.
- Imaging detects abscesses requiring orthopedic intervention.
Observation:
- This essay highlights acute pediatric osteomyelitis associated with physeal separation.
- Cases presented showed large subperiosteal fluid collections and significant epiphyseal-metaphyseal separation.
- This finding can be mistaken for traumatic injury in the absence of a trauma history.
Findings:
- Acute osteomyelitis in children can present with physeal separation.
- Subperiosteal fluid collections are a key indicator.
- Radiographs can reveal this separation, aiding diagnosis.
Implications:
- Recognizing physeal separation in pediatric osteomyelitis is vital.
- This radiographic finding can prevent misdiagnosis as simple trauma.
- Early identification ensures appropriate management of bone infections.
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