Ultrasonic features of acute osteomyelitis in infants.

Zavadovskaya V.D., Polkovnikova S.A., Maslikov V.M.

A feature of osteomyelitis in infants is epimetaphysis localization, which is determined by the blood circulation in these extremity segments. Ultrasound scanning is the best method of studying the debut features and dynamics of acute osteomyelitis in this localization because it is safe for the child's health. Purpose. Development of ultrasound semiotics for epimetaphysis osteomyelitis in in-fants, depending on the extent of the inflammatory process.
1 - Siberian State Medical University. 2 - Emergency Hospital №2. Tomsk, Russia.



 

 

 

 

 

 

 

 

 

Materials and Methods. The study included 37 children (20 boys and 17 girls) with acute hematogenous osteomyelitis aged from birth to 8 months with the localization of the inflammatory process in the long bones. Ultrasonography (ultrasound scanner Mindray M7, China, multifrequency linear transducer 9-12 MHz) and X-ray (X-ray machine Appollo, Italy) were performed in all patients. Osteomyelitis was confirmed in all patient by the surgical intervention. Results. Patients were divided into three groups. The first group (n = 5; 13.51%) - children with epiphyseal involvement of extremity, the second group (n = 4; 10.81%) - with metaphyseal involvement, the third group (n = 28; 75.67%) - with the involvement of the epiphysis and metaphysis and involvement of the growth zone in inflammation process. There were no children with isolated localization of the purulent focus in the growth zone. Conclusion. The main feature of ultrasonic epiphyseal form of osteomyelitis is the presence of destruction signs of the epiphysis as a hyperechogenic/anechogenic local area in the epiphyseal cartilage in the absence of changes in the growth plate, metaphysis and in the periosteum. The identification of the anechogenic focus in the metaphysis near fuzzy growth zone without crossing it, as well as thickening, increased echogenicity of the periosteum, in the absence of changes in the epiphyseal cartilage, ossification of the nucleus can be considered a form of metaphyseal acute hematogenous osteomyelitis. The main features of metaepiphyseal form of osteomyelitis is the formation of a defect with the interruption of growing zone. Eligible single error in ultrasound in each group shows underestimation of indirect ultrasound signs in early diagnosis.

 

Keywords: ultrasound diagnostics, osteomyelitis, muscle-skeletal system.

 

Corresponding author:Polkovnikova S.A., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: : Zavadovskaya V.D., Polkovnikova S.A., Maslikov V.M. Ultrasonic features of acute osteomyelitis in infants. REJR. 2017; 7 (2):94-101. DOI:10.21569/2222-7415-2017-7-2-94-101./em>

Received: 29.03.2017 Accepted:05.05.2017