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Congress: ECR25
Poster Number: C-14879
Type: Poster: EPOS Radiologist (scientific)
DOI: 10.26044/ecr2025/C-14879
Authorblock: G. Fichera, A. Michielin, M. Zuliani, R. Stramare, F. Causin, C. Giraudo; Padua/IT
Disclosures:
Giulia Fichera: Nothing to disclose
Anna Michielin: Nothing to disclose
Monica Zuliani: Nothing to disclose
Roberto Stramare: Nothing to disclose
Francesco Causin: Nothing to disclose
Chiara Giraudo: Nothing to disclose
Keywords: Paediatric, MR, Diagnostic procedure, Infection
Purpose Osteomyelitis is a bacterial or fungal infection of the bone that is more common in children than in adults (Restrepo 2024). It can develop due to hematogenous spread, direct trauma, or after surgery. Long bones, particularly the femur and tibia, are commonly affected due to their rich metaphyseal blood supply, a predisposing factor to bacterial colonization (Restrepo 2024).Common clinical symptoms include fever, localized pain and tenderness of the affected bone, swelling, and limited range of motion. Infants may show irritability...
Read more Methods and materials We searched our electronic database for children (<18 years old) admitted to the Emergency Room of our tertiary center from January 2020 to March 2024 with acute skeletal pain without any referred traumatic injury, who underwent an MR within seven days. Requests with at least one of the following hypotheses “infection”, inflammation”, “tumor” according to clinical assessment and eventually to the findings of first level examinations (US and/or X-ray) were included. For each patient, demographics, affected skeletal area, clinical symptoms...
Read more Results Fifty-four patients (21 female; 6±4 years-old) matched the inclusion criteria. Overall, the most investigated areas were the thigh and the calf (nine patients each); in patients with osteomyelitis, the hip, the elbow, and the tibia were mostly involved (4 each, 7.4%) (Figure 1). Twenty-five patients (46.3%) had a diagnosis of osteomyelitis at MR. The following diagnoses were achieved in patients without osteomyelitis: arthritis and myositis (five each), osteonecrosis, subcutaneous abscess, and lymphangioma (two each) (Figure 2), cellulitis, osteoid osteoma, and...
Read more Conclusion In our tertiary center the requests for osteomyelitis were inaccurate in half of the cases and clinical and laboratory findings were not proper indicators of skeletal infection demonstrating that it can be a challenging diagnosis still in need of a better clinical workflow.
Read more References Restrepo R, Park HJ, Karakas SP, et al. Bacterial osteomyelitis in pediatric patients: a comprehensive review. Skeletal Radiol. 2024;53(10):2195-2210. doi:10.1007/s00256-024-04639-x Gornitzky AL, Kim AE, O'Donnell JM, Swarup I. Diagnosis and Management of Osteomyelitis in Children: A Critical Analysis Review. JBJS Rev. 2020;8(6):e1900202. doi:10.2106/JBJS.RVW.19.00202 Pineda C, Espinosa R, Pena A. Radiographic Imaging in Osteomyelitis: The Role of Plain Radiography, Computed Tomography, Ultrasonography, Magnetic Resonance Imaging, and Scintigraphy. Semin Plast Surg. 2009;23(2):80-9. doi:10.1055/s-0029-1214160 – Pubmed Wu J, Gorbachova T, Morrison W, Haims A. Imaging-Guided Bone Biopsy...
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