Ultrasound in children with osteomyelitis

Ultrasound (US) is a proven method of identifying subperiosteal abscess formation in osteomyelitis, but its precise role in the management of children with the condition is contentious. We reviewed nine children in whom US was used in the management of long bone osteomyelitis, including ribs. US was helpful in confirming the presence of a subperiosteal abscess in those children with an appropriate history and localizing signs. In these circumstances a bone scan is unnecessary. Problems were encountered when US failed to identify a subperiosteal abscess, because of the early stage of the disease process, and in multifocal abnormalities. In these circumstances a bone scan should still be performed.