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Acute Osteomyelitis of Child
Lauren M. Ladd, MD; Cheryl A. Petersilge, MD, MBA
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Infection of bone marrow, symptoms < 14 days
                • Diagnosed by at least 1 of following
                  • (+) culture of bone or periosteum
                  • (+) blood culture and imaging consistent with osteomyelitis
                  • (+) blood culture and abnormal clinical exam consistent with osteomyelitis
                  • Abnormal imaging and clinical examination consistent with osteomyelitis

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Nuclear Medicine Findings

                        • Image-Guided Biopsy

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        Selected References

                                        1. Alaia EF et al: MRI nomenclature for musculoskeletal infection. Skeletal Radiol. 50(12):2319-47, 2021
                                        2. Agarwal A et al: Bone and joint infections in children: acute hematogenous osteomyelitis. Indian J Pediatr. 83(8):817-24, 2016
                                        3. Carmody O et al: Acute haematogenous osteomyelitis in children. Ir Med J. 107(9):269-70, 2014
                                        4. Ceroni D et al: Primary epiphyseal or apophyseal subacute osteomyelitis in the pediatric population: a report of fourteen cases and a systematic review of the literature. J Bone Joint Surg Am. 96(18):1570-5, 2014
                                        5. Hirji H et al: Paediatric acquired pathological vertebral collapse. Skeletal Radiol. 43(4):423-36, 2014
                                        6. Yoo WJ et al: Primary epiphyseal osteomyelitis caused by mycobacterium species in otherwise healthy toddlers. J Bone Joint Surg Am. 96(17):e145, 2014
                                        7. Henninger B et al: Ewing sarcoma versus osteomyelitis: differential diagnosis with magnetic resonance imaging. Skeletal Radiol. 42(8):1097-104, 2013
                                        8. Inusa BP et al: Dilemma in differentiating between acute osteomyelitis and bone infarction in children with sickle cell disease: the role of ultrasound. PLoS One. 8(6):e65001, 2013
                                        9. Riise ØR et al: Childhood osteomyelitis-incidence and differentiation from other acute onset musculoskeletal features in a population-based study. BMC Pediatr. 8:45, 2008
                                        10. Connolly SA et al: MRI for detection of abscess in acute osteomyelitis of the pelvis in children. AJR Am J Roentgenol. 189(4):867-72, 2007
                                        11. Palestro CJ et al: Combined labeled leukocyte and technetium 99m sulfur colloid bone marrow imaging for diagnosing musculoskeletal infection. Radiographics. 26(3):859-70, 2006
                                        12. Kao HC et al: Acute hematogenous osteomyelitis and septic arthritis in children. J Microbiol Immunol Infect. 36(4):260-5, 2003
                                        13. Connolly LP et al: Acute hematogenous osteomyelitis of children: assessment of skeletal scintigraphy-based diagnosis in the era of MRI. J Nucl Med. 43(10):1310-6, 2002
                                        14. Jaramillo D et al: Osteomyelitis and septic arthritis in children: appropriate use of imaging to guide treatment. AJR Am J Roentgenol. 165(2):399-403, 1995
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Definitions

                                                    • Infection of bone marrow, symptoms < 14 days
                                                      • Diagnosed by at least 1 of following
                                                        • (+) culture of bone or periosteum
                                                        • (+) blood culture and imaging consistent with osteomyelitis
                                                        • (+) blood culture and abnormal clinical exam consistent with osteomyelitis
                                                        • Abnormal imaging and clinical examination consistent with osteomyelitis

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Nuclear Medicine Findings

                                                              • Image-Guided Biopsy

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              Selected References

                                                                              1. Alaia EF et al: MRI nomenclature for musculoskeletal infection. Skeletal Radiol. 50(12):2319-47, 2021
                                                                              2. Agarwal A et al: Bone and joint infections in children: acute hematogenous osteomyelitis. Indian J Pediatr. 83(8):817-24, 2016
                                                                              3. Carmody O et al: Acute haematogenous osteomyelitis in children. Ir Med J. 107(9):269-70, 2014
                                                                              4. Ceroni D et al: Primary epiphyseal or apophyseal subacute osteomyelitis in the pediatric population: a report of fourteen cases and a systematic review of the literature. J Bone Joint Surg Am. 96(18):1570-5, 2014
                                                                              5. Hirji H et al: Paediatric acquired pathological vertebral collapse. Skeletal Radiol. 43(4):423-36, 2014
                                                                              6. Yoo WJ et al: Primary epiphyseal osteomyelitis caused by mycobacterium species in otherwise healthy toddlers. J Bone Joint Surg Am. 96(17):e145, 2014
                                                                              7. Henninger B et al: Ewing sarcoma versus osteomyelitis: differential diagnosis with magnetic resonance imaging. Skeletal Radiol. 42(8):1097-104, 2013
                                                                              8. Inusa BP et al: Dilemma in differentiating between acute osteomyelitis and bone infarction in children with sickle cell disease: the role of ultrasound. PLoS One. 8(6):e65001, 2013
                                                                              9. Riise ØR et al: Childhood osteomyelitis-incidence and differentiation from other acute onset musculoskeletal features in a population-based study. BMC Pediatr. 8:45, 2008
                                                                              10. Connolly SA et al: MRI for detection of abscess in acute osteomyelitis of the pelvis in children. AJR Am J Roentgenol. 189(4):867-72, 2007
                                                                              11. Palestro CJ et al: Combined labeled leukocyte and technetium 99m sulfur colloid bone marrow imaging for diagnosing musculoskeletal infection. Radiographics. 26(3):859-70, 2006
                                                                              12. Kao HC et al: Acute hematogenous osteomyelitis and septic arthritis in children. J Microbiol Immunol Infect. 36(4):260-5, 2003
                                                                              13. Connolly LP et al: Acute hematogenous osteomyelitis of children: assessment of skeletal scintigraphy-based diagnosis in the era of MRI. J Nucl Med. 43(10):1310-6, 2002
                                                                              14. Jaramillo D et al: Osteomyelitis and septic arthritis in children: appropriate use of imaging to guide treatment. AJR Am J Roentgenol. 165(2):399-403, 1995