Related Experiment Videos
Pelvic musculoskeletal infection in infants -- diagnostic difficulties and radiological features
1Department of Radiology, Alder Hey Children's Hospital, Liverpool, UK.
Insights
Primary pelvic musculoskeletal infections are rare in infants. Diagnosis can be delayed due to non-specific symptoms, but imaging like MRI is crucial for identifying these challenging pediatric infections.
Area of Science:
- Pediatric Infectious Diseases
- Musculoskeletal Imaging
- Infant Health
Background:
- Pelvic musculoskeletal infections are uncommon in infants.
- Previously, these infections were thought to arise from adjacent structures.
- Primary infections originating in pelvic muscles are rarely documented.
Purpose of the Study:
- To report on primary pelvic musculoskeletal infections in infants.
- To describe the clinical presentation and diagnostic challenges.
- To evaluate the utility of various radiological investigations.
Main Methods:
- Retrospective case series of five infants under one year old.
- Clinical data review including presenting symptoms and diagnostic delays.
- Analysis of radiological findings from plain films, ultrasound, scintigraphy, computed tomography (CT), and magnetic resonance imaging (MRI).
Main Results:
- Five cases of primary pelvic musculoskeletal infection in infants presented within one year.
- Clinical features were non-specific, mimicking hip or vascular issues, leading to delayed diagnosis in four patients.
- MRI was the most effective imaging modality for diagnosis and delineating infection extent.
Conclusions:
- Primary pelvic musculoskeletal infections can occur in infants.
- Early diagnosis is challenging due to non-specific symptoms.
- A combination of imaging techniques, particularly MRI, is essential for accurate diagnosis and management.
Abstract:
Musculoskeletal infection involving the pelvis has rarely been reported in infants. When such infections involve the pelvic muscles they are generally believed to result from secondary spread from adjacent structures. We report five cases of primary pelvic musculoskeletal infection affecting infants <1 year, all of which presented during a 1-year period. In two patients the infection appeared to arise primarily in muscle. Clinical features were generally non-specific and often misleading, mimicking hip (4/5) or vascular (3/5) pathology; as a result, diagnosis was delayed in four patients. Radiological investigation was required to make the diagnosis and delineate the extent of the lesion in all cases. Magnetic resonance imaging (MRI) was the most useful imaging technique, accurately identifying the infection and its extent in all cases in which it was used. However, plain films, ultrasound (US), scintigraphy and computed tomography (CT) were all useful in individual cases and have a role in the primary investigation of these difficult infections. The clinical presentation of pelvic musculoskeletal infection in infants and the role of the various radiological investigations in its diagnosis is discussed.