Comparison of clinical effect of CT diagnosis and X-ray Plain film diagnosis in children with Acute Osteomyelitis during emergency treatment

Jing Fan,Li He,Jin Li,Junfen Zhou,Yanyan Guo

doi:10.1590/fst.18420

Abstract

Background Acute osteomyelitis has great harmfulness. To conduct comparative analysis on the difference of clinical effect of CT diagnosis and X-ray plain film diagnosis in children with acute osteomyelitis during emergency treatment, to provide guidance for the diagnosis and treatment of this disease. Methods The study subjects were 32 children with acute osteomyelitis. All the children were examined by X-ray and CT before surgery. Image characteristics and detection rates of bone destruction, changes in periosteum and cortex were compared. Funding X-ray scanning image: for the children with acute osteomyelitis in the early stage, the symptoms were demonstrated as that the submuscular space disappeared, and the boundary between subcutaneous and muscle tissues was blurred. CT scanning image: the images in early stage showed hyperemia and edema of soft tissue, with a slightly lower density of lesion, disappearance of interfascicular space, and a low-density abscess cavity in the center. The detection rate of bone destruction in CT scan was obviously higher than that in plain X-ray, in terms of bone destruction in special morphology, bone shell destruction in residual expansion, circular bone destruction, and peripheral bone defect, and the detection rate of periosteum and cortex changes was higher than that in plain X-ray, The diagnostic sensitivity and specificity of CT in children with acute osteomyelitis during emergency treatment were better than that of X-ray plain film. Interpretation CT scan has good diagnostic accuracy, sensitivity and specificity during emergency treatment of this disease.

Highlights

Acute hematopoietic osteomyelitis is known as acute osteomyelitis, which is not common in pediatric clinic but has great harmfulness
Most children with acute osteomyelitis are infected with pyogenic bacteria through hematogenous invasion of the connective tissue of the bone marrow to cause inflammatory response, while a few were spread from adjacent soft tissue infection or secondary to open fractures (Funk & Copley, 2017)
Inclusion criteria: Determined and diagnosed (Yeddes et al, 2017) according to relevant criteria for acute osteomyelitis specified in Surgery (4th version), confirmed through pathology of puncture operation; examined with X-ray plain film and CT scan before operation, complete image data; the age of sick children ranged from 3 months to 12 years old; The parents of sick children know and agree to the content and purpose of this study

Summary

Introduction

Acute hematopoietic osteomyelitis is known as acute osteomyelitis, which is not common in pediatric clinic but has great harmfulness. Failing to be treated timely and effectively, the bone structure of children may be damaged and lead to disability, and the infection may spread to the whole body, seriously endangering the safety of life; Some patients may turn into chronic osteomyelitis with prolonged disease course, which may affect the nutrition and growth of children (Waddell et al, 2017). This disease has always been one of the difficult pediatric clinical problems, especially non-traumatic acute osteomyelitis whose symptoms are similar with myeloma, which is more prone to misdiagnosis or missed diagnosis, and delay the treatment. Interpretation: CT scan has good diagnostic accuracy, sensitivity and specificity during emergency treatment of this disease

Methods

Results

Conclusion