Related Experiment Video
Updated: May 31, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Subperiosteal abscess in pediatric acute osteomyelitis: ultrasound-guided percutaneous aspiration in three cases
1Musculoskeletal Radiology, Clínica Alemana de Santiago, Hospital de niños Exequiel González Cortés, Santiago, Chile. gcorralg@alemana.cl.
Insights
Ultrasound-guided percutaneous aspiration offers a minimally invasive alternative for treating pediatric subperiosteal abscesses complicating acute osteomyelitis. This approach demonstrated rapid improvement in three children, avoiding surgical drainage.
Area of Science:
- Pediatric Orthopedics
- Medical Imaging
- Infectious Diseases
Background:
- Subperiosteal abscess is a known complication of pediatric acute osteomyelitis.
- Traditional management involves surgical drainage, but minimally invasive options lack robust evidence in children.
Purpose of the Study:
- To evaluate the feasibility and clinical value of ultrasound-guided percutaneous aspiration for pediatric subperiosteal abscesses.
- To present successful case studies of this minimally invasive therapeutic alternative.
Main Methods:
- Three pediatric cases of acute osteomyelitis with subperiosteal abscesses were treated.
- Ultrasound-guided percutaneous aspiration using fine-caliber needles was performed.
- Imaging (ultrasound and MRI) assessed abscess characteristics and ruled out intraosseous involvement.
Main Results:
- Ultrasound revealed subperiosteal collections (4-7 mm thickness) without significant intraosseous abscess.
- Percutaneous aspiration successfully yielded purulent material, with Staphylococcus aureus identified.
- All patients experienced rapid clinical and laboratory improvement within 24-48 hours.
Conclusions:
- Ultrasound-guided percutaneous aspiration is a feasible and potentially valuable minimally invasive treatment for select pediatric subperiosteal abscesses.
- This method led to successful outcomes without complications, recurrence, or need for surgery in the reported cases.
Abstract:
Subperiosteal abscess is a recognized complication of pediatric acute osteomyelitis and has traditionally been managed with surgical drainage. Evidence supporting minimally invasive ultrasound-guided therapeutic alternatives in children remains limited. We report three pediatric cases of acute osteomyelitis complicated by subperiosteal abscesses successfully treated with ultrasound-guided percutaneous aspiration. In all patients, ultrasound demonstrated subperiosteal collections measuring 4-7 mm in thickness, with no evidence of substantial intraosseous abscess on ultrasound or magnetic resonance imaging. Percutaneous aspiration was performed under real-time ultrasound guidance using fine-caliber needles, without indwelling catheter placement. Purulent material was obtained in all cases, with cultures positive for methicillin-sensitive Staphylococcus aureus. All patients showed rapid clinical and laboratory improvement within 24-48 h, without procedure-related complications, recurrence during follow-up, or subsequent need for surgical drainage. These cases illustrate the feasibility and potential clinical value of ultrasound-guided percutaneous aspiration as a minimally invasive therapeutic option in carefully selected pediatric patients with isolated subperiosteal abscesses.
Related Concept Videos
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:26Brain Abscess l: Introduction
01:17Ultrasonography
During an ultrasonography procedure, a handheld device called a...