Pelvic osteomyelitis: a diagnostic challenge in children

Christina Weber-Chrysochoou, Natascha Corti, Philippe Goetschel, Stefan Altermatt, Thierry A G M Huisman, Christoph Berger

Research output: Contribution to journalArticle

Abstract

Background: Acute hematogenous osteomyelitis (AHOM) in children usually occurs in tubular bones. Acute hematogenous osteomyelitis of the pelvis is rare and is often not recognized primarily. Methods: To review the experience with pelvic AHOM at our institution, we analyzed records from children diagnosed with pelvic AHOM (1984-2003) and compared with those reported in the literature. Results: Among 220 children with AHOM (median age, 6.4 years), those 19 (9%) with pelvic AHOM were significantly older (median age, 9.0 years; range, 0.04-15.6). All children presented with limping or refused to walk. Twelve of 19 patients were febrile, 16 of 18 had elevated C-reactive protein (>20 mg/L), and 6 of 19 had leukocytes greater than 12 G/L. Staphylococcus aureus was isolated from blood or bone aspirates in 9 of 17 patients, and Streptococcus pneumoniae was isolated in 1. Scintigraphy was diagnostic in 15 of 15 children, and magnetic resonance imaging in 7 of 7 children. The mean time between initial symptoms and diagnosis was 3 days (range, 1-8 days). Infection resolved completely in all children after antibiotic therapy. Conclusion: Pelvic AHOM should be considered in children with limping and pain referred to the hip, thigh, or abdomen. Diagnosis by scintigraphy or magnetic resonance imaging followed by local puncture and microbiological workup allows for specific antibiotic treatment and results in an excellent outcome of pelvic AHOM.

Original languageEnglish (US)
Pages (from-to)553-557
Number of pages5
JournalJournal of Pediatric Surgery
Volume42
Issue number3
DOIs
StatePublished - Mar 2007
Externally publishedYes

Keywords

  • Children
  • Osteomyelitis
  • Pelvis

ASJC Scopus subject areas

  • Surgery

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    Weber-Chrysochoou, C., Corti, N., Goetschel, P., Altermatt, S., Huisman, T. A. G. M., & Berger, C. (2007). Pelvic osteomyelitis: a diagnostic challenge in children. Journal of Pediatric Surgery, 42(3), 553-557. https://doi.org/10.1016/j.jpedsurg.2006.10.048