Acute Arthritis/Osteomyelitis in Children

OSTEOMYELITIS IN CHILDREN: Osteomyelitis (OM) is defined as an infection of the bone marrow and adjacent osseous structures with potential surrounding soft tissue extent. It can occur at any age, generally in children 1 –16 years old. In children, it is predominantly caused by hematogenous spread of infection, typically bacterial. Generally, the metaphysis is involved. Transphyseal spread to the epiphysis and joint is rare but can occur in children younger than 18 months, or in older children with closed growth p lates, due to a different blood perfusion to the epiphysis. The first imaging modality of choice is conventional radiography (CR), but CR has limited sensitivity in early stages. Osseous destruction is evident only 10–14 days after the initial infection. In low-grade osteomyelitis, nonspecific sof t tissue swelling and subtle bone resorption or a lytic lesion at the metaphysis may be seen, as in more advanced stages, lytic bone destruction, and periosteal formation are seen. Magnetic resonance imaging (MRI) is the preferred modality for early detection of lesions. Brodie’s abscess is a subt ype of osteomyelitis typically seen in children, with intraosseous abscess formation (Figure 1). Another specific subtype of OM is chronic recurrent multifocal osteomyelitis (CRMO), which is characterized by multiple sterile inflammatory bone lesions with a relapsing and remitting course. Whole-body MRI is increasingly being used for evaluation. OM has a variable imaging app...
Source: Journal of the Belgian Society of Radiology - Category: Radiology Source Type: research