Acta Ortopédica Mexicana

Figueras-Coll G, Albertí-Fitó G, Torrededia-Del Rio L, Hernández-Hermoso JA
Ischial osteomyelitis in children. Two case reports
Acta Ortop Mex 2013; 27 (2)

Language: Español
References: 10
Page: 119-122
PDF: 65.26 Kb.

[Fulltext - PDF]

ABSTRACT

Ischial osteomyelitis is a bone infection that is very infrequent during childhood and is diagnosed by excluding other more frequent conditions. The definitive diagnosis is made with puncture biopsy, which allows instituting targeted antibiotic therapy. We present herein two clinical cases of two children who had a favorable course. In both cases the findings of the initial X-rays were unremarkable. The physical exam did not show total limitation of the coxofemoral joint but it did show ischial tenderness. The MRI showed images compatible with ischial osteitis. The ischial puncture biopsy was diagnostic in both cases. At the 24-month follow-up both children are leading a normal life. Conclusions: Ischial osteomyelitis is an entity to consider in children with coxalgia once other more frequent conditions have been ruled out. The diagnosis is possible with a thorough iconographic study toget.


Key words: osteomyelitis, ischion, child.


REFERENCES

  1. Milch H: Pyogenic Osteomyelitis of the Ischium. Injuries and Surgical Diseases of the Ischium. 1958: 98-103.

  2. Jenzri M, Safi H, Nessib MN, Jalel C, Smida M, Ammar C, Ghachem MB: Acute hematogenous osteomyelitis of the obturator rim in seven children. Rev Chir Orthop Reparatrice Appar Mot 2008; 94(2): 168-73.

  3. McPhee E, Eskander JP, Eskander MS, Mahan ST, Mortimer E: Imaging in pelvis osteomyelitis: support for early magnetic resonante imaging. J Pediatr Orthop 2007; 27(8): 903-9.

  4. Klein JD, Leach KA: Pediatric pelvic osteomyelitis. Clin Pediatr (Phila) 2007; 46(9): 787-90.

  5. Kloiber R, Udjus K, McIntyre W, Jarvis J: The scintigraphic and radiographic appearance of the ischiopubicsynchondroses in normal children and in osteomyelitis. Pediatr Radiol 1988; 18: 57-61.

  6. Zvulunov A, Gal N, Segev Z: Acute hematogenous osteomyelitis of the pelvis in childhood: diagnostic clues and pitfalls. Pediatr Emerg Care 2003; 19(1): 29-31.

  7. Rand N, Mosheiff R, Matan Y, Porat S, Shapiro M, Liebergall M: Osteomyelitis of the pelvis. J Bone Joint Surg 1993; 75-B(5): 731-3.

  8. Davidson D, Letts M, Khoshhal K: Pelvic osteomyelitis in children: a comparison of decades from 1980-1989 with 1990-2001. J Pediatr Orthop 2003; 23(4): 514-21.

  9. Jarvis J, McIntyre W, Udjus K, Kloiber R: Osteomyelitis of the ischiopubicsynchondrosis. J Pediatr Orthop 1985; 5(2): 163-6.

  10. Nixon GW: Hematogenous osteomyelitis of metaphyseal equivalent locations. Am J Roentgenol 1978; 130: 123-9.