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The potential role of pan-immune-inflammation value in differentiating pediatric osteomyelitis from soft tissue
Gang Ren1, Xin Wang1, Zhenjiang Liu1
1Department of Orthopedics, Center for Children's Health, Capital Medical University, Beijing, China.
Insights
The pan-immune-inflammation value (PIV) effectively differentiates pediatric osteomyelitis (OM) from soft tissue infections (STI). This new biomarker shows promise for earlier and more accurate diagnosis in children.
Area of Science:
- Pediatric infectious diseases
- Biomarker discovery
- Diagnostic imaging
Background:
- Distinguishing pediatric osteomyelitis (OM) from soft tissue infection (STI) is challenging due to similar clinical and laboratory signs.
- The pan-immune-inflammation value (PIV) is a novel biomarker reflecting systemic immune status and inflammation.
- Current diagnostic methods for OM and STI in children require improvement for accuracy and timeliness.
Purpose of the Study:
- To assess the diagnostic value of PIV in differentiating pediatric OM from STI.
- To determine if PIV can serve as a reliable and accessible biomarker for distinguishing these conditions.
- To explore the potential of PIV in aiding early diagnosis and guiding treatment decisions.
Main Methods:
- A retrospective study analyzed data from 59 children with OM and 310 with STI.
- Demographic, clinical, and laboratory parameters were collected, and PIV was calculated.
- Statistical analyses, including multivariate analysis and ROC curve analysis, were performed to evaluate PIV's diagnostic utility.
Main Results:
- Children with OM exhibited significantly higher PIV levels than those with STI (512.6 vs. 220.3, P<0.001).
- PIV was identified as an independent predictor for OM (OR=1.012, P<0.001).
- PIV demonstrated good diagnostic accuracy (AUC=0.892), with sensitivity of 84.7% and specificity of 82.3%. Combining PIV with CRP improved accuracy (AUC=0.926).
Conclusions:
- PIV is a promising biomarker for differentiating pediatric OM from STI.
- Its ready availability and effectiveness suggest potential for improved diagnostic capabilities.
- Further validation is recommended to confirm PIV's role in early diagnosis and management of pediatric infections.
Background:
Distinguishing between pediatric osteomyelitis (OM) and soft tissue infection (STI) remains a diagnostic challenge due to overlapping clinical and laboratory features. The pan-immune-inflammation value (PIV) is a new comprehensive biomarker calculated from counts of blood cells taken from outside the main part of the body, showing the overall condition of the immune system and inflammation in the body. This study aimed to evaluate the diagnostic utility of PIV in differentiating OM from STI in children.
Methods:
The retrospective study conducted a review of past data involving children who visited Department of Orthopedics, Center for Children's Health, Capital Medical University from January 2020 to May 2025. The cohort consisted of 59 children with OM and 310 with STI. Demographic, clinical, and laboratory parameters were systematically collected for all participants. PIV was calculated and analyzed.
Results:
The OM group showed higher PIV levels compared to the STI group (512.6±198.4 vs. 220.3±115.7, P<0.001). Multivariate analysis identified PIV as an independent predictor for OM [odds ratio (OR) =1.012, 95% confidence interval (CI): 1.008-1.016, P<0.001]. The area under the receiver operating characteristic (ROC) curve (AUC) for PIV was 0.892 (95% CI: 0.845-0.939), with a sensitivity of 84.7% and specificity of 82.3% at the optimal cutoff value of 385.6. The combination of PIV with C-reactive protein (CRP) further improved diagnostic accuracy (AUC =0.926).
Conclusions:
PIV is a promising, readily available biomarker that shows potential to effectively differentiate pediatric OM from STIs, potentially aiding in early diagnosis and appropriate management upon further validation.
