Diagnostic imaging of pediatric hematogenous osteomyelitis: lessons learned from a multi-modality approach

Santos, José María Mellado

doi:10.1007/s00330-006-0187-4

Cited by 39 publications

(15 citation statements)

References 37 publications

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“…The palaeopathological identification of AO in children's remains may benefit if all the bones showing new bone formation are radiographed. The radiograph should reveal first subperiosteal resorption, ‘creating radiolucencies with cortical bone that then may progress to irregular destruction with periosteal new bone formation’ (Blickman et al ., :L57; also see Capitanio & Kirkpatrick, ; Mellado Santos, ). However, as Resnick & Kransdorf () pointed out, radiological diagnosis of AO is difficult.…”

Section: Discussionmentioning

confidence: 95%

“…According to clinical evidence, classic bone destruction and periosteal bone formation are not seen in plain radiographs until 10–12 days after the onset of symptoms (Blickman et al ., ; Pineda et al ., ), although early subtle changes may be not obvious within 5 to 7 days in children (Pineda et al ., ). Moreover, in subacute osteomyelitis, diagnosed 2 weeks after the onset of symptoms (Harik & Smeltzer, ), abscesses typically involve the medullary cavity, and lytic areas surrounded by reactive sclerosis are usually present in plain radiographs (Mellado Santos, ). No bone remodelling or radiological signs compatible with osteomyelitis were found in skeleton 278.…”

Section: Discussionmentioning

confidence: 99%

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Skeletal and Surgical Evidence for Acute Osteomyelitis in Non‐Adult Individuals

Santos

Suby

2012

Intl J of Osteoarchaeology

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Osteomyelitis is a non-specific infection of bone and bone marrow. In the past acute osteomyelitis (AO) led to high mortality especially in non-adults. Nevertheless, its diagnosis in archaeological populations is rare. Documented individuals with known cause of death offer a unique opportunity to study this condition. This paper aims to describe the bone lesions in non-adults diagnosed with AO at the Coimbra University Hospital (CUH) and now belonging to the Coimbra Identified Skeletal Collection (CISC). Moreover, mortality rates and demographic profiles for individuals aged ≤18 years old and diagnosed with AO in the CUH, between 1923 and 1929, were also determined. The 5 (1%) non-adults in the CISC with AO listed as cause of death were selected for this study and their bones were analysed macroscopically and radiologically. The skeletal remains of one individual revealed a small area of new bone formation in the shaft of the left femur. Radiography of this bone showed a radio-opaque area in the diaphysis. The other four individuals show evidence of surgical treatment, responsible for many cases of disability in the past. In the 7-year period under analysis, 122 juveniles were diagnosed with osteomyelitis and admitted for surgery at the CUH, 43 (35.2%) of which were diagnosed with AO. Sixty-five percent of the cases of AO occurred between the ages of 8 and 15 years, with males twice as frequently affected as females, and lower limb bones were involved in 91% of AO cases. AO was responsible for 76.9% of the deaths. This study of pre-antibiotic non-adults may help to recognize skeletal signs of AO and their surgical treatment in unidentified skeletal remains.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Skeletal and Surgical Evidence for Acute Osteomyelitis in Non‐Adult Individuals

Santos

Suby

2012

Intl J of Osteoarchaeology

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“…MRI is a sensitive method for osteomyelitis detection. A low signal intensity is seen in the bone marrow on T1-weighted sequences and fluid and inflammatory cell infiltration results in high signal intensity on T2-weighted and other fluid sensitive MRI sequences [3] , [11] , [12] . Fat saturation sequences are useful to differentiate bone marrow edema from the fatty tissue of bone marrow and subcutaneous tissue [10] .…”

Section: Discussionmentioning

confidence: 99%

Intra and extramedullary fat globules as an MRI marker for osteomyelitis

Godoy

Neto

Rodrigues

et al. 2018

Radiology Case Reports

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Magnetic resonance imaging (MRI) findings of acute osteomyelitis vary from non-specific bone marrow edema to more reliable signs such as bone destruction, periosteal reaction, and sequestrum. In some cases, imaging features could overlap with other conditions such as trauma and bone tumors. Intra and extramedullary fat globules are a helpful MRI marker for osteomyelitis, as shown in the following case report. We report the MRI findings of a 15-year-old young man with distal femur osteomyelitis, associated with intra and extramedullary fat globules.We present the MRI features of the case and emphasize the importance of noting additional signs of osteomyelitis to make a precise diagnosis.

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“…T2 fat-suppressed, or short-tau inversion-recovery (STIR) images are particularly helpful in detecting extensive signal changes which are a combination of infected bone marrow and surrounding reactive oedema. Additionally, MRI can also detect soft tissue inflammatory changes and help to differentiate phlegmon from abscess formation [ 10 ] ( Figure 2 ).…”

Section: Acute Bacterial Osteomyelitismentioning

confidence: 99%

Multimodality imaging of greater trochanter lesions

et al. 2021

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IntroductionGreater trochanter (GT) lesions are relatively uncommon. They can be traumatic, infective including tuberculosis, inflammatory, and neoplastic (primary and metastatic osseous lesions). Although imaging of greater trochanter lesions remains essential for differential diagnoses, an image-guided biopsy is a mainstay for diagnosis and to guide subsequent management.Material and methodsA retrospective search for the word ‘greater trochanter’ was performed of a computerised radiology information system (CRIS) of a tertiary referral centre for orthopaedic oncology over a period of 12 years (2007-2019). This revealed 6019 reports with 101 neoplasms. The imaging, histology, and demography were reviewed by a dedicated musculoskeletal radiologist.ResultsWe identified 101 GT neoplasms with a mean age of 51.5 years (range 6 to 85 years) and a slight female predominance of 1.2 : 1 (46 males and 55 females). Using 30 years of age as a cut-off, we further segregated the patient cohort into 2 groups: 26 (25.74%) lesions in patients less than 30 years age and the remaining 75 (74.26%) lesions in patients over 30 years old. Chondroblastoma was the most common neoplasm in patients below 30 years of age, and metastases were the most common neoplasms in patients over 30 years of age.ConclusionsGreater trochanter pathologies show a broad spectrum of aetiologies. Imaging including radiographs, computed tomography, magnetic resonance imaging, and nuclear medicine scans help to narrow down the differentials diagnosis.

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Diagnostic imaging of pediatric hematogenous osteomyelitis: lessons learned from a multi-modality approach

Cited by 39 publications

References 37 publications

Skeletal and Surgical Evidence for Acute Osteomyelitis in Non‐Adult Individuals

Skeletal and Surgical Evidence for Acute Osteomyelitis in Non‐Adult Individuals

Intra and extramedullary fat globules as an MRI marker for osteomyelitis

Multimodality imaging of greater trochanter lesions

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