Key role of magnetic resonance imaging in the diagnosis of infections around the hip and pelvic girdle mimicking septic arthritis of the hip in children

Infections around the hip and the pelvic girdle mimicking septic hip arthritis are rare conditions in the pediatric population requiring urgent treatment. They are not readily diagnosed because of rarity, resemblance to septic hip, and unclear pathophysiology, which often results in misdiagnosis, delayed diagnosis, and delayed treatment. The aim of this study was to prove the key role of magnetic resonance imaging (MRI) as the first-line modality in making a early definite diagnosis of an uncommon perihip infection in children. We retrospectively reviewed 20 children with a provisional diagnosis of unilateral septic hip who were confirmed finally to have perihip infections and combined with concomitant osteomyeltis using MRI. All patients were treated with intravenous antibiotics with or without abscess aspiration until normalization of clinical symptoms and laboratory tests including serum C-reactive protein and erythrocyte sedimentation rate. All infections healed successfully and the final C-reactive protein was recovered to a mean of 0.37 mg/dl (range 0.01–0.78 mg/dl) without recurrence or complication. Although the MRI is costly and limited in practical application, it was found to be effective as a primary diagnostic tool for an early, accurate diagnosis of infections around the hip and the pelvic girdle in children to correctly guide the decision and the approach for treatment.
Source: Journal of Pediatric Orthopaedics B - Category: Orthopaedics Tags: Hip Source Type: research

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Conclusion: Although treatment algorithms are an attractive tool to guide clinicians and resource allocation, they need to take into account the local population characteristics before routine implementation. Level of Evidence: Level IV–retrospective cohort study.
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Infection Source Type: research
Publication date: Available online 24 September 2020Source: Journal of Clinical Orthopaedics and TraumaAuthor(s): Hosam E. Matar, Yacer Asran, Subhasis Basu, Tim N. Board, Asim Rajpura
Source: Journal of Clinical Orthopaedics and Trauma - Category: Orthopaedics Source Type: research
CONCLUSION: IP vancomycin was effective for treatment of invasive S. aureus infection in this case. This approach should be considered in patients undergoing PD for whom peripheral i.v. access options are limited and/or not preferred. PMID: 32914168 [PubMed - as supplied by publisher]
Source: American Journal of Health-System Pharmacy : AJHP - Category: Drugs & Pharmacology Authors: Tags: Am J Health Syst Pharm Source Type: research
Conclusions: When considering a child with an irritable knee, a heterogeneity of potential underlying pathologies and combinations of pathologies are possible. Importantly, the age of the patient and CRP can guide a clinician when considering further workup. Older patients with a higher admission CRP value warrant an immediate magnetic resonance imaging, as they are likely to have osteomyelitis, which was associated with worse outcomes when compared with patients with isolated septic arthritis. Level of Evidence: Level III—retrospective research study.
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Selected Topics Source Type: research
CONCLUSION: When a patient with ONFH has an unexplained elevation of ESR and/or CRP, concomitant septic arthritis of the hip should be suspected. PMID: 31687776 [PubMed - as supplied by publisher]
Source: Surgical Technology International - Category: Surgery Tags: Surg Technol Int Source Type: research
ero A Abstract Facet joint septic arthritis is a rare cause of spinal infection in children with only four cases reported. The transmission pathway is believed to be haematogenous in 72% of cases. The authors present the case of a 13-year-old boy hospitalised for acute lumbosciatalgia, limp and fever, with pain upon palpation of the paravertebral muscles, a positive Laségue signal and elevated serum inflammatory markers. The initial lumbar computerised tomography (TC) scan revealed no abnormalities in the interapophyseal joints. After improving on treatment with analgesics and antibiotics, he was readmitted...
Source: Anales del Sistema Sanitario de Navarra - Category: General Medicine Authors: Tags: An Sist Sanit Navar Source Type: research
Conclusions: We found lower sensitivity and specificity and higher false-positive rates for the Rosenfeld criteria in the hip for our geographically distinct population. Using the Rosenfeld criteria, MRIs would have been ordered unnecessarily in half of our series. Because of potential differences in regional microbiology and anatomic-specific factors, general predictive criteria for coexisting PAI based a single geographic region may be less generalizable to cases of hip sepsis in other geographic areas such as the Northeastern United States. Level of Evidence: Level 4—retrospective cohort study.
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Selected Topics Source Type: research
Authors: Esmaeilnejad-Ganji SM, Esmaeilnejad-Ganji SMR Abstract Brucellosis is a common global zoonotic disease, which is responsible for a range of clinical manifestations. Fever, sweating and musculoskeletal pains are observed in most patients. The most frequent complication of brucellosis is osteoarticular involvement, with 10% to 85% of patients affected. The sacroiliac (up to 80%) and spinal joints (up to 54%) are the most common affected sites. Spondylitis and spondylodiscitis are the most frequent complications of brucellar spinal involvement. Peripheral arthritis, osteomyelitis, discitis, bursitis and tenos...
Source: World Journal of Orthopaedics - Category: Orthopaedics Tags: World J Orthop Source Type: research
Authors: Kawashiri SY, Edo Y, Kawakami A Abstract A 53-year-old Japanese man experienced fever/neck pain, and neck magnetic resonance imaging revealed a spinal epidural abscess. The following day, he developed a palpable mass with evident inflammatory signs in the right sternoclavicular joint (SCJ) with severe pain. Ultrasound revealed synovitis with remarkable power Doppler signals in the right SCJ. Blood cultures yielded Streptococcus agalactiae growth. After 12 days, ultrasound showed right distal clavicle bone erosion. His symptoms improved with long-term parenteral antibiotic treatment, but the right SCJ joint...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Publication date: November 2018Source: Journal of the American College of Radiology, Volume 15, Issue 11, SupplementAuthor(s): Expert Panel on Pediatric Imaging:, Nabile M. Safdar, Cynthia K. Rigsby, Ramesh S. Iyer, Adina L. Alazraki, Sudha A. Anupindi, Dianna M.E. Bardo, Brandon P. Brown, Sherwin S. Chan, Tushar Chandra, Jonathan R. Dillman, Scott R. Dorfman, Matthew D. Garber, H. F. Samuel Lam, Jie C. Nguyen, Alan Siegel, Roger F. Widmann, Boaz KarmazynAbstractImaging plays in important role in the evaluation of the acutely limping child. The decision-making process about initial imaging must consider the level of suspic...
Source: Journal of the American College of Radiology - Category: Radiology Source Type: research
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