ACR Appropriateness Criteria ® Acutely Limping Child Up To Age 5

Imaging plays in important role in the evaluation of the acutely limping child. The decision-making process about initial imaging must consider the level of suspicion for infection and whether symptoms can be localized. The appropriateness of specific imaging examinations in the acutely limping child to age 5 years is discussed with attention in each clinical scenario to the role of radiography, ultrasound, nuclear medicine, computed tomography, and magnetic resonance imaging. Common causes of limping such as toddler ’s fracture, septic arthritis, transient synovitis, and osteomyelitis are discussed.
Source: Journal of the American College of Radiology : JACR - Category: Radiology Authors: Tags: Appropriate use criteria Source Type: research

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Abstract Rat-bite fever is a rarely diagnosed illness caused by Streptobacillus moniliformis . Although this disease is distributed worldwide, there have been few cases reported in Europe. Here, we report a case of vertebral osteomyelitis and sternoclavicular septic arthritis caused by S. moniliformis in a Portuguese patient previously bitten by a rat. Laboratory diagnosis was performed using molecular identification. This is the first case report of rat-bite fever in Portugal. The case described here serves as a reminder for physicians to consider this diagnosis in patients who have developed fever syndromes after being i...
Source: Revista da Sociedade Brasileira de Medicina Tropical - Category: Tropical Medicine Source Type: research
Authors: George E, Rajalakshmi A Abstract Melioidosis is an infectious disease caused by gram negative bacterium Burkholderia pseudomallei. It is a soil and water pathogen and transmitted to humans through inoculation or inhalation. This disease is considered endemic in India and largely remains under reported. The most common presentation is pneumonia and bacteraemia, which can present acutely and as septic shock. Chronic presentation include-abscess, septic arthritis, osteomyelitis. The major risk factors are diabetes, liver disease, renal disease, chronic lung disease. In this article 18 cases have been reviewed...
Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
Pediatric populations are prone to infections and most can be managed appropriately in a primary care setting. There are, however, some infectious processes that require intervention or management from an orthopedic surgeon. The most serious infectious processes in the pediatric population from an orthopedic standpoint are osteomyelitis and septic arthritis. Early recognition of these conditions and prompt referral of serious infections, as well as the ability to differentiate which infections should be referred for specialist evaluation is critical.
Source: Pediatric Clinics of North America - Category: Pediatrics Authors: Source Type: research
CONCLUSION: A correct and early diagnosis, prompt implementation of adequate antimicrobial therapy, and focus control, when indicated, are critical to a better prognosis. PMID: 31783013 [PubMed - as supplied by publisher]
Source: Jornal de Pediatria - Category: Pediatrics Authors: Tags: J Pediatr (Rio J) Source Type: research
We report the first case, to our knowledge, of isolated intramedullary spinal lesions secondary to M. haemophilum. This case involved a patient with newly diagnosed human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). He developed significant Immune Reconstitution Inflammatory Syndrome (IRIS) during his treatment. M. haemophilum should be on the differential for isolated intramedullary spinal lesions, particularly in immunocompromised patients. Given our patient’s severe IRIS, patients with HIV and M. haemophilum infection should be closely monitored for IRIS and treated aggressively. In high...
Source: IDCases - Category: Infectious Diseases Source Type: research
Objectives: To perform a comprehensive description of the epidemiology of Streptococcus pyogenes invasive disease in the pediatric population in 2 regions of Spain (Catalonia and Gipuzkoa) through 12 years. Methods: All S. pyogenes isolates causing invasive disease in pediatric patients between 2005 and 2016 were included. The emm-type and the presence of 13 exotoxin genes (speA, speB, speC, speF, speG, speH, speI, speJ, speK, speL, speM, smeZ, ssa and slo) were determined in all 93 available isolates and the Multi Locus Sequece Typing in 10% of isolates of each different emm-type. Results: Overall, 103 cases of S....
Source: The Pediatric Infectious Disease Journal - Category: Infectious Diseases Tags: Original Studies Source Type: research
Osteomyelitis, infected non-unions, septic arthritis, spondylodiscitis, hematogeneous osteomyelitis, implant-associated infections, necrotizing fasciitis, periprosthetic joint infections etc. are different manifestations of musculoskeletal infections. However, they do have one thing in common: each of them put a high burden on the patient, the patient's family, the surgeon and the health care system with frequent fatal consequences, such as severe limitations of the affected limb up to amputations, depression, loss of job and further negative socio-economic consequences for the patient [1 –3].
Source: Injury - Category: Orthopaedics Authors: Tags: Editorial Source Type: research
Rationale: Toothpick puncture (TPP) is a penetrating injury that can result in bringing pathogens to the deep space. Such penetrating wounds are typically of pinpoint size with initial symptoms appearing subtle. Consequently, the injury itself is often neglected by patients, or is not detected during physical examinations by medical doctors. Reported complications from such injuries include osteomyelitis and septic arthritis, mostly due to delayed treatment. Patient concerns: A diabetic patient aged 83-year-old presented a 2-day history of skin redness, swelling, and tenderness over his forearm following a TPP a week ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
This article highlights the role of nuclear medicine in standardizing the diagnostic approach in patients with infectious/inflammatory diseases, in particular in peripheral osteomyelitis, septic arthritis, prosthetic joint infections, infected diabetic foot and spinal infections. The authors reveal the role of the most common radionuclides tests, with their advantages and clinical indications, to achieve an adequate diagnosis of infection and inflammation.ResumenLas enfermedades inflamatorias e infecciosas osteoarticulares pueden tener graves consecuencias para el paciente si no se diagnostican a tiempo. En las últi...
Source: Revista Espanola de Medicina Nuclear e Imagen Molecular - Category: Nuclear Medicine Source Type: research
Knee pain is common in children, particular during adolescence. A detailed history and clinical examination often will identify the likely cause. Health care professionals looking after children and young people should be aware of the common causes of knee pain and red flags which are a feature of more sinister causes. Common causes of knee pain include patellofemoral problems, apophysitis such as Osgood Schlatter's disease and Sinding-Larsen-Johansson Syndrome, osteochondritis dissecans, trauma, rheumatological causes such as juvenile idiopathic arthritis, and infective causes as such septic arthritis and osteomyelitis.
Source: Paediatrics and Child Health - Category: Pediatrics Authors: Tags: Symposium: connective tissue and bone Source Type: research
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