Early Roentgen Observations in Acute Osteomyelitis

Capitanio, Marie A.; Kirkpatrick, John A.

doi:10.2214/ajr.108.3.488

Cited by 131 publications

(30 citation statements)

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“…The facts of the lower frequency of acute inflammation in the teeth with pericoronal radiolucency below the crown, and a similar frequency to that without pericoronal radiolucency suggest that it should be investigated whether pericoronal radiolucency below the crown is a preexisting and underlying risk factor predisposing acute inflammation, or whether pericoronal radiolucency below the crown is a causal factor of acute inflammation, since acute inflammation may arise even if there is no pericoronal radiolucency below the crown. Indeed, radiolucency is diagnosed after 10–12 days,9 2–3 weeks10 after initial symptom, and not until 2–4 weeks11 by conventional radiographs. Nevertheless, observation of pericoronal radiolucency below the crown is still expected to predict acute inflammation because of the higher frequency of acute inflammation in the elderly with pericoronal radiolucency as shown in the present study.…”

Section: Discussionmentioning

confidence: 99%

Acute inflammation in horizontal incompletely impacted third molar with radiolucency in the elderly

Yamaoka

Ono²,

Takahashi³

et al. 2009

CIA

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Although radiolucency has been shown as a risk of infection, the poorly understood effects of aging on radiolucency correlate with acute pericoronitis, which has a high risk of infection extending any complications. We reviewed the records of 346 consecutive patients aged more than 41 years to evaluate whether pericoronal radiolucency below the crown in mandibular horizontal incompletely impacted third molars is related to acute inflammation. The frequency of acute inflammation in teeth with pericoronal radiolucency below the crown was similar to that in teeth without; however, the odds ratio of acute inflammation exhibited in women aged more than 61 years compared to women aged 41–50 years was 9.77 (95% confidence interval [CI]: 1.67–57.29; P < <0.05), and in women aged more than 61 years compared to women aged 51–60 years was 26.25 (95% CI: 2.94–234.38; P < 0.01). The odds ratio of severe acute inflammation exhibited in men aged more than 61 years compared to men aged 41–50 years was 16.67 (95% CI: 1.76–158.27; P < 0.01). These odds ratios indicate an association of acute pericoronitis, including the severe forms of acute inflammation that result from pericoronitis, with pericoronal radiolucency below the crown in the elderly.

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Section: Discussionmentioning

confidence: 99%

Acute inflammation in horizontal incompletely impacted third molar with radiolucency in the elderly

Yamaoka

Ono²,

Takahashi³

et al. 2009

CIA

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“…34 Plain radiography is less helpful than other imaging techniques as osteolytic changes or periosteal elevation occur most often 10-21 days after the onset of symptoms. 2,8,35 However, once apparent, the extent of bony change provides a good correlate to the severity of the disease. Plain radiographs also provide a baseline for comparison of subsequent change.…”

Section: Imagingmentioning

confidence: 99%

Duration of intravenous antibiotic therapy for children with acute osteomyelitis or septic arthritis: a feasibility study

Sukhtankar

Arch

Ahmad

et al. 2017

Health Technol Assess

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Declared competing interests of authors: Saul N Faust was UK chief investigator and University Hospital Southampton NHS Foundation Trust principal investigator for a Cubist-sponsored clinical trial of daptomycin against standard of care antibiotic therapy in paediatric osteomyelitis. All funds were paid into accounts within the NHS trust or university and not paid as personal fees. He reports consultancy fees for advisory board participation paid into accounts within the NHS trust or university (not personal fees) from vaccine manufacturers and antimicrobial agent manufacturers, including AstraZeneca, Cubist, Merck, GlaxoSmithKline (GSK) and Pfizer, outside the submitted work. He acts as principal investigator for clinical trials and other studies conducted on behalf of University Hospital Southampton NHS Foundation Trust/ University of Southampton that are sponsored by vaccine manufacturers and antimicrobial agents, and has participated in advisory boards for vaccine manufacturers. Adam Finn reports grants and personal fees from Sanofi Pasteur MSD Ltd (SPMSD), and grants and personal fees from GSK, outside the submitted work. In addition, prior to October 2014, the University of Bristol and University Hospitals Bristol NHS Foundation Trust received funding for research conducted by Adam Finn and for consultancy and lectures from Pfizer, GSK, SPMSD and Novartis, who manufacture licensed and developmental meningococcal vaccines. Stuart C Clarke acts as principal investigator for clinical trials and other studies conducted on behalf of University Hospital Southampton NHS Foundation Trust/University of Southampton that are sponsored by vaccine manufacturers but receive no personal payments from them. He has participated in advisory boards for vaccine manufacturers and has received financial assistance from vaccine manufacturers to attend conferences, but receives no personal payments for this work. All grants and honoraria are paid into accounts within the respective NHS trusts or universities. Jethro Herberg reports that he was an investigator for a Cubist-sponsored clinical trial of daptomycin against standard of care antibiotic therapy in paediatric osteomyelitis; he received no personal payments. Andrew Riordan reports that the trust, but not he, has received funding for research sponsored by vaccine manufacturers and antimicrobial agents. He was lead editor for an e-learning package on meningitis produced by the Royal College of Paediatric and Child Health, funded by an unrestricted grant from Novartis Vaccines. Marieke Emonts was Newcastle upon Tyne Hospitals Foundation Trust's principal investigator for a Cubist-sponsored clinical trial of daptomycin against standard of care antibiotic therapy in paediatric osteomyelitis. All grants and honoraria are paid into accounts within the NHS trust or university; she received no personal payment of any kind. Marieke Emonts reports acting as site principle investigator on behalf of the Newcastle upon Tyne Hospitals Foundation Trust/Newcastle University for clinical tr...

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“…Frequent differentials include ligament injuries or fractures. Common causes for the failure in its early diagnosis include the radiographic changes begin around 10-12 weeks [5], hence immediate films may be insignificant; also the soft tissue changes mimic any ligament or superficial infection [1,2,3]. Furthermore, primary subacute osteomyelitis may present the above features minus the fever; hence diagnosis would be delayed till after bony destruction has occurred [3].…”

Section: Discussionmentioning

confidence: 99%

A Limping Child: On A First Look It Is Hip Or Knee In Origin! No! It’s A Talus Osteomyelitis

Ganaisan¹,

Singh²,

Kumar³

et al. 2013

IJOS

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Isolated osteomyelitis of the talus in a child is very rare incidence [1,2]. Children presenting with pain and limp to emergency department are predominantly investigated for pathologies of hip or knee, hence a condition originating from talus is frequently missed. A delay in its diagnosis are precursors to gait and bony deformity in future where the cost of disability is a huge burden to the patient. We present a case of osteomyelitis of talus where initially it was a missed diagnosis but due to awareness and alertness of the treating physician it was identified and treated early. CASE REPORTA 2 year old child presented to Emergency Department with pain and swelling of her left foot and ankle for 1 month. Her parents claimed the child had sustained what was initially thought as a superficial injury to the foot about 6 weeks earlier-hit by a stone while playing. Seen and treated by a general practitioner -no radiographs were done then. Over the subsequent month she experienced increasing swelling and pain-affecting mobility, with an occasional fever. During the initial admission, the foot was warm, tender and swollen till the ankle. There was no neurovascular deficit, open wounds or discharging sinus. Based on radiographic and clinical findings, a diagnosis of crack fracture of the left talus dome with overlying cellulites was made -secondary to the initial trauma . A broad spectrum antibiotic was started and the limb immobilized in a below knee backslab cast. She was discharged home after 2 days as the constituitional symptoms had resolved and cellulitis appeared to respond to the treatment-a review planned a week later. By the next follow-up the child could weight bear , the pain and erythema had subsided but swelling persisted. The antibiotics were continued for another week, and a 3 weekly review planned. At 9 weeks, in view of the persistent swelling and lytic changes obvious on radiographs a MRI was planned. Differentials were AVN and Osteomyelitis. The MRI , done 12 weeks from date of admission ( 18 weeks post trauma) was reported as Chronic Osteomyelitis with underlying pathological fractures.

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Early Roentgen Observations in Acute Osteomyelitis

Cited by 131 publications

References 3 publications

Acute inflammation in horizontal incompletely impacted third molar with radiolucency in the elderly

Acute inflammation in horizontal incompletely impacted third molar with radiolucency in the elderly

Duration of intravenous antibiotic therapy for children with acute osteomyelitis or septic arthritis: a feasibility study

A Limping Child: On A First Look It Is Hip Or Knee In Origin! No! It’s A Talus Osteomyelitis

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