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[Osteomyelitis in the pagetic tibia]

J C Rénier1, L Pidhorz, F Parvery

  • 1Service de Rhumatologie, CHU Angers.

Revue Du Rhumatisme (Ed. Francaise : 1993)
|October 1, 1994
PubMed
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Osteomyelitis in Paget's bone is rare. This study details three cases of tibia osteomyelitis in Paget's disease patients, often requiring amputation due to persistent infection.

Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Bone Metabolism

Background:

  • Paget's disease of bone is a chronic condition characterized by abnormal bone remodeling.
  • Osteomyelitis, a bone infection, is an exceptionally rare complication in patients with Paget's disease.
  • Previous literature documented only one case of osteomyelitis in pagetic bone.

Observation:

  • This report details the management of three patients presenting with osteomyelitis specifically affecting the tibia in the context of Paget's disease.
  • In all three cases, the initial point of infection was a cutaneous lesion.
  • Microbiological analysis identified Gram-negative organisms in all patients, with one case also involving the anaerobe Bacteroides melaninogenicus.

Findings:

  • Despite treatment, one patient was lost to follow-up before infection resolution.

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  • Two patients ultimately required amputation of the affected limb due to persistent infection, following extensive antimicrobial therapy lasting 23 and 4 years, respectively.
  • The findings highlight the challenges in treating osteomyelitis in the unique context of pagetic bone.

    • Implications:

    • This study underscores the rarity and significant morbidity associated with osteomyelitis in Paget's disease.
    • Effective management strategies for this rare complication remain critical.
    • Further research may be needed to explore optimal treatment protocols for osteomyelitis in pagetic bone to prevent severe outcomes like amputation.