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Role of ultrasound in the diagnosis of paediatric acute osteomyelitis

Amit Kumar Paliwal
Amit Kumar Paliwal
, 
Ravinder Sahdev
Ravinder Sahdev
, 
Ankur Deshwal
Ankur Deshwal
 et 
Birma Ram
Birma Ram
   | 08 mars 2021
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Article Category: research-article
Publié en ligne: 08 mars 2021
Pages: 34 - 40
Reçu: 31 oct. 2020
Accepté: 06 janv. 2021
DOI: https://doi.org/10.15557/jou.2021.0005
Mots clés
© 2021 Polish Ultrasound Society. Published by Medical Communications Sp. z o.o.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Fig. 1.

Deep soft tissue fluid collection around bone. Axial ( A ) and sagittal ( B ) sections through distal thigh showing deep fluid collection (white star) in relation to distal femoral metaphysis (white arrow)
Deep soft tissue fluid collection around bone. Axial ( A ) and sagittal ( B ) sections through distal thigh showing deep fluid collection (white star) in relation to distal femoral metaphysis (white arrow)

Fig. 2.

Hyperechoic deep soft tissue fluid collection with superiosteal abscess. Axial ( A ) and sagittal ( B ) sections through proximal leg showing hyperechoic deep fluid collection (white star) in relation to proximal femoral metaphysis (white arrow) and superiosteal collection (white empty arrow)
Hyperechoic deep soft tissue fluid collection with superiosteal abscess. Axial ( A ) and sagittal ( B ) sections through proximal leg showing hyperechoic deep fluid collection (white star) in relation to proximal femoral metaphysis (white arrow) and superiosteal collection (white empty arrow)

Fig. 3.

Colour Doppler. A. Increased vascularity around bone and superiosteal collection (white arrow). B. Increased vascularity around bone, deep soft tissue (white star) and superiosteal collection (white empty arrow)
Colour Doppler. A. Increased vascularity around bone and superiosteal collection (white arrow). B. Increased vascularity around bone, deep soft tissue (white star) and superiosteal collection (white empty arrow)

Fig. 4.

MRI of the right proximal leg ( A. T1W axial image, B. T2W axial image, C. PDFS axial image, D. Coronal PDFS image, E. Sagittal PDFS images) subperiosteal abscess (white empty arrow) and altered marrow signals (white star)
MRI of the right proximal leg ( A. T1W axial image, B. T2W axial image, C. PDFS axial image, D. Coronal PDFS image, E. Sagittal PDFS images) subperiosteal abscess (white empty arrow) and altered marrow signals (white star)

Fig. 5.

Intra op image – surgical drainage subperiosteal abscess left distal femur
Intra op image – surgical drainage subperiosteal abscess left distal femur

Fig. 6.

Algorithm for the early diagnosis of paediatric AOM on USG
Algorithm for the early diagnosis of paediatric AOM on USG

Distribution of diagnosed AOM cases (n = 5)

Case Age (years) Gender Clinical profile Site of involvement Day of USG scan after onset
1 6 Male Pain and swelling, left distal thigh Left distal femoral metaphysis 4
2 9 Male Pain, right proximal leg Right proximal tibial metaphysis 7
3 6 Female a. Swelling, pain, redness, right distal thigh and knee b. Fever Right distal femoral metaphysis 4
4 12 Male a. Pain, left proximal thigh b. Fever Left proximal femoral metaphysis 3
5 8 Male Pain and swelling, right distal thigh Right distal femoral metaphysis 5

Distribution of cases as per diagnosis after the final evaluation (n =18)

Diagnosis Number of cases Percentage
AOM 5 27.8
Soft tissue haematoma 5 27.8
Cellulitis 4 22.2
Osteosarcoma 1 5.56
Osteoid osteoma 1 5.56
Fractures 2 11.1

Sonographic findings in confirmed cases of AOM at presentation (n = 5)

USG finding Number of cases Percentage
Deep soft tissue fluid collection around the bone 5 100
Periosteal thickening or elevation with subperiosteal fluid collection 4 80
Increased vascularity within or around the periosteum on colour Doppler 4 80
eISSN:
2451-070X
Langue:
Anglais
Périodicité:
4 fois par an
Sujets de la revue:
Medicine, Basic Medical Science, other
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