Childhood osteomyelitis: imaging characteristics

Joost Van Schuppen,Martine M A C Van Doorn,Rick R Van Rijn

doi:10.1007/s13244-012-0186-8

Joost Van Schuppen, Martine M A C Van Doorn + Show 1 more

Open Access

https://doi.org/10.1007/s13244-012-0186-8

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Abstract

BackgroundThe purpose of this review is to illustrate the imaging findings of childhood osteomyelitis. The diagnosis of childhood osteomyelitis can be challenging. Clinical presentation and laboratory results can differ and are relatively unreliable. To date, its role in the assessment of treatment efficacy is not yet clear.MethodsThis review article provides an overview of the different imaging modalities and imaging characteristics of childhood osteomyelitis. Levels of evidence for different modalities are presented.ResultsPaediatric radiology plays a pivotal role in the diagnosis of childhood osteomyelitis and can also be used to guide therapy and intervention.ConclusionAlthough imaging is essential in the diagnostic process, cooperation between the physician and radiologist remains the cornerstone in accurately diagnosing childhood osteomyelitis.Main Messages• Imaging plays a pivotal role in the diagnosis of childhood osteomyelitis.• Cooperation between the clinician and radiologist is a very important aspect of making the diagnosis.• The initial imaging modality in childhood osteomyelitis is conventional imaging.• Normal conventional imaging does not exclude osteomyelitis.

Highlights

Childhood osteomyelitis can be a challenging problem to both the clinician and the radiologist as the clinical presentation can be variable in severity, and laboratory results are relatively unsupportive in the diagnostic workup
Osteomyelitis can follow after trauma, where a metaphysical haematoma can function as a focus of infection [4]
An osteomyelitis with symptoms longer than 2 weeks is defined as subacute osteomyelitis and shows more classical signs on conventional imaging, including single or laminated periostal reactions, and well-circumscribed metaphysical lucency in the long bones, known as Brodie’s abscess (Fig. 4) [20]

Summary

Introduction

Childhood osteomyelitis can be a challenging problem to both the clinician and the radiologist as the clinical presentation can be variable in severity, and laboratory results are relatively unsupportive in the diagnostic workup. With respect to radiological imaging, it will focus on the application of radiological techniques in the diagnosis of childhood osteomyelitis and the reported levels of evidence for the use of these techniques (Table 1). In the majority of cases it will be the only imaging technique used in the diagnosis and treatment of childhood osteomyelitis.

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