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Clinical and ultrasound features of 46 children with suppurative osteoarthritis: experience from two centers
Sai-Feng Huang1, Yue Teng1, Hui-Qing Shi1
1Department of Ultrasound, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350011, China.
Insights
High-resolution ultrasound aids in diagnosing pediatric musculoskeletal infections. This study identified key ultrasonographic features of pyogenic arthritis and osteomyelitis, improving early diagnosis and treatment.
Area of Science:
- Pediatric Radiology
- Musculoskeletal Infections
- Diagnostic Imaging
Background:
- Diagnosing musculoskeletal infections in children presents significant challenges.
- Advancements in ultrasound technology offer unique advantages for examining pediatric musculoskeletal conditions.
Purpose of the Study:
- To summarize the ultrasonographic and clinical characteristics of children diagnosed with pyogenic arthritis and osteomyelitis.
- To establish a simpler and more effective diagnostic basis for clinical treatment of these conditions.
Main Methods:
- Fifty children with suspected osteomyelitis or arthritis underwent ultrasound diagnosis.
- Ultrasound findings were compared with magnetic resonance imaging (MRI) and surgical outcomes.
- Clinical and ultrasonographic characteristics were analyzed.
Main Results:
- Of 50 patients, 46 confirmed suppurative infections; 26 osteomyelitis, 20 arthritis.
- Osteomyelitis showed subperiosteal abscesses, bone destruction, and marrow/joint abscesses, primarily in long bones.
- Arthritis involved joint pus, capsule thickening, and hip dislocation, with all cases affecting the hip joint.
Conclusions:
- Key ultrasonographic features of pyogenic osteoarthritis include subperiosteal abscess, bone destruction, and joint abscess with dislocation.
- These findings enhance early diagnosis and differentiation of pyogenic osteoarthritis.
- The study provides a reliable basis for guiding clinical treatment decisions.
Objective:
Diagnosing musculoskeletal infections in children is challenging. In recent years, with the advancement of ultrasound technology, high-resolution ultrasound has unique advantages for musculoskeletal children. The aim of this work is to summarize the ultrasonographic and clinical characteristics of children with pyogenic arthritis and osteomyelitis. This study provides a simpler and more effective diagnostic basis for clinical treatment.
Methods:
Fifty children with osteomyelitis or arthritis were diagnosed via ultrasound, and the results of the ultrasound diagnosis were compared with those of magnetic resonance imaging and surgery. Clinical and ultrasound characteristics were also analyzed.
Results:
Out of 50 patients, 46 were confirmed to have suppurative infection by surgical and microbiological examination. Among these 46 patients, 26 were diagnosed with osteomyelitis and 20 had arthritis. The manifestations of osteomyelitis were subperiosteal abscess (15 patients), bone destruction (17 patients), bone marrow abscess (9 patients), and adjacent joint abscess (13 patients). Osteomyelitis mostly affects the long bones of the limbs, femur and humerus (10 and 9 patients, respectively), followed by the ulna, radius, tibia and fibula (one patient each). The manifestations of arthritis were joint pus (20 patients) and joint capsule thickening (20 patients), and hip dislocation (8 patients). All the patients had arthritis involving the hip joint.
Conclusion:
Subperiosteal abscess, bone destruction, and joint abscess with dislocation are ultrasonographic features of pyogenic osteoarthritis. The findings of this work can improve the early diagnosis and differentiation of pyogenic osteoarthritis and provide a reliable basis for treatment.
