Contiguous Osteomyelitis of Distal Extremities in Children

Objective. To evaluate the burden of Contiguous Osteomyelitis (COM) in pediatric patients with cellulitis/abscess of hands/feet. Methods. Children aged 0-18 years, treated from 2009 to 2019 for cellulitis/abscess of hands/feet, who either had Magnetic Resonance Imaging at presentation, or Roentgenogram >10 days after symptom-onset, were included. Two-tailed T-test was used to compare patients with and without COM. P-value < .05 deemed statistically significant. Results. Twenty of forty-one patients with abscess/cellulitis of distal extremities were diagnosed with COM. Between groups, no differences identified in trauma-to-presentation time, antibiotic treatment for >48 hours before admission, abscess versus cellulitis, location of infection, presence of fever, or signs of infection. Conclusion. In our cohort, clinical presentation did not differentiate COM. Imaging helped diagnose patients with COM, who would otherwise receive a shorter antibiotic course. Hands/feet imaging in pediatric patients hospitalized with cellulitis/abscess should be considered to identify COM and customize treatment. Further research is warranted.