К вопросу о комплексной лучевой диагностике воспалительных заболеваний костей у детей на ранней стадии процесса

Abstract

Aim: to study the possibilities of diagnostic radiology methods for changes in metaphyses and epiphyses at an early stage of the inflammatory process in children aged 1 and older and adolescents. Patients and Methods: 76 emergency patients with a diagnosis of acute metaepiphysial hematogenous osteomyelitis were examined using standard radiography (SR), ultrasonography (US), magnetic resonance imaging (MRI) and computed tomography (CT). The age of the patients ranged from 1 to 18 years. All patients in the admission department underwent US and SR with a mandatory examination of the contralateral region. After analyzing the obtained data, additional examination algorithms were formed using MRI and CT. Results and Discussion: US of the targeted area was descriptive concerning the soft tissue pathological component: paraosseous soft tissues edema was determined in 75%, structural changes of the joint, in particular, synovitis — in 78.9%, joint effusion — in 57.9%. X-ray examination had a limited opportunity to detect destructive changes in bone tissue at the early stages of the pathological process (6.6%). At the same time, MRI revealed the maximum number of semiotic signs of acute hematogenous osteomyelitis, the most significant of which were: trabecular bone marrow edema (100%), periosteal changes (96.1%) and extraosseous changes (98.5%). CT was performed in 26 patients with multifocal disease, as well as in the late stage of the inflammatory process for preoperative planning. Bone destruction at an early stage occurred in 32.7% of patients, a change in the growth area — in 81.0 % of cases. Along with these semiotic signs, sequesters (55.3 %) and fistula tracts (31.3%) were visualized. Conclusion: the obtained results made it possible to systematize information on the diagnostic radiology efficacy for acute metaphyseal and epiphyseal lesions in the early stage of the inflammatory process in children aged 1 and older and adolescents. KEYWORDS: osteomyelitis, epiphysis, metaphysis, diagnostic radiology, pediatrics. FOR CITATION: Sholokhova N.A., Olkhova E.B. On the issue of complex diagnostic radiology of inflammatory bone diseases in children at an early stage. Russian Medical Inquiry. 2021;5(5):330–334 (in Russ.). DOI: 10.32364/2587-6821-2021-5-5-330-334.