Ultrasound-Guided Diagnosis of Femoral Osteomyelitis and Abscess

Abstract

Skin and soft tissue infections are common disease presentations to the pediatric emergency department, and rapid and accurate identification of potentially serious skin and soft tissue infections is critical. In cases of atraumatic musculoskeletal pain with systemic complaints, a bacterial etiology must be ruled out. Point-of-care ultrasonography is increasingly common in the pediatric emergency department and assists in rapid and accurate identification of a variety of disease processes. We present a case of a 14-year-old adolescent boy with atraumatic right knee pain to illustrate the benefits of point-of-care ultrasonography in the timely diagnosis of musculoskeletal and soft tissue pathology. Moreover, we describe the use of ultrasound in procedural guidance of deep-space fluid aspiration, with an eventual diagnosis of femoral osteomyelitis. Ultrasonographic techniques and the emergent work-up and management of osteomyelitis are reviewed.

Unusual ultrasound diagnosis of hair implantation osteomyelitis of the thumb

“…This was confirmed from US-guided aspiration of pus from this collection. As a result of the quick and early diagnosis, the team was able to direct further urgent investigations and provide appropriate care in a timely manner 30…”

Moving Beyond the Stethoscope: Diagnostic Point-of-Care Ultrasound in Pediatric Practice

“…117 Ultrasound is also well known for the diagnosis of congenital dysplasia of the hip and may be performed by pediatricians, neonatologists, or radiologists. 118 Novel applications such as POCUS for the diagnosis of osteomyelitis as well as ultrasound-guided aspiration of periosteal pus 119 A, Foreign body (arrow) with posterior shadowing (shown by the asterisk) identified on ultrasound of the palmar aspect of the hand, which was unable to be visualized on radiography. B, Ultrasound guided the extraction of this foreign body.…”