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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
PubMed

Insights

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.
Keywords:
BoneChildrenInfectionMagnetic resonance imagingOsteomyelitisSubperiosteal abscess

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