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[Discitis in small children (author's transl)]
Insights
Early diagnosis of childhood discitis is crucial. Spinal radiography and technetium-99 scintigraphy are essential for prompt identification and management of this condition in young children.
Area of Science:
- Pediatric Infectious Diseases
- Pediatric Radiology
- Pediatric Orthopedics
Background:
- Discitis in children under three years old presents diagnostic challenges.
- Etiological factors for discitis in this age group remain largely undiscovered.
- Delayed diagnosis can occur, ranging from 8 days to 3 months.
Observation:
- Initial symptoms included difficulty walking and abdominal pain in some cases.
- Radiographic findings consistently showed disc space pinching, with ill-defined vertebral plates in some instances.
- Long-term follow-up revealed partial disc space restoration in two-thirds of cases, with one experiencing late collapse.
Findings:
- Early perilesional bone sclerosis was observed in two cases, while one showed late sclerosis.
- No long-term sequelae such as fusion, vertebra plana, or scoliosis were noted.
- Radiography of the spinal column is recommended even without overt symptoms.
Implications:
- Prompt diagnosis of discitis in young children is vital.
- Spinal radiography is a key diagnostic tool for suspected disc lesions.
- Technetium-99 scintigraphy is highlighted as the definitive method for early discitis diagnosis.
Abstract:
Discitis was diagnosed in 5 children under 3 years of age, the initial clinical manifestations being difficulty in walking and abdominal pains in one case. Diagnosis was not made before periods varying from 8 days to 3 months, and no etiological basis for the disease was discovered. Pinching of the disc was always present in the first radiographic image, and the vertebral plate was ill-defined in 3 cases. Repeat radiological examinations were carried out in 3 children after 6 months, 2 and 5 years respectively. There was partial restauration of the disc space in 2 cases; the last one presented signs of late collapse after early recuperation. Early perilesional bone sclerosis was noted in 2 cases, while it was posterior and late in one child. There were no sequelae (fusion, vertebra plana, scoliosis). Two investigations are essential if a disc lesion is suspected: -- radiography of the spinal column, even if there are no disturbances in walking or abdominal pains. -- scintigraphy with technitium 99, which is the only means of establishing an early diagnosis.