title: Photopenic bone scan osteomyelitis: a clinical perspective.
abstract: Eighty-one pediatric patients had nuclear bone-imaging studies confirmatory of osteomyelitis during the past 10 years. Seven (8.6%) of 81 had "cold" osteomyelitis. These seven patients were all toxic [mean temperature (T), 39.9 degrees C; heart rate (HR), 145 beats/min], all had markedly elevated erythrocyte sedimentation rates (mean ESR, 76 mm/h), and six of seven had both confirmatory bone and blood cultures. All patients required surgical intervention. The average length of hospital stay for these seven patients was 32 days (range, 8-65 days). A control group of matched patients with "hot" osteomyelitis was constructed for statistical evaluation. This analysis confirmed significantly increased temperature, resting pulse rate, ESR, length of hospital stay, and rate of surgical intervention in patients with cold versus hot osteomyelitis. Patients with osteomyelitis presenting as a cold defect on bone imaging appeared to have a more aggressive type of bone infection, often requiring aggressive medical and surgical intervention adequately to control this infectious process.
authors.affiliation: Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, USA. penn17jan@aol.com
authors.forename: W T
authors.initials: WT
authors.lastname: Pennington
authors.forename: M P
authors.initials: MP
authors.lastname: Mott
authors.forename: J G
authors.initials: JG
authors.lastname: Thometz
authors.forename: J R
authors.initials: JR
authors.lastname: Sty
authors.forename: D
authors.initials: D
authors.lastname: Metz
mesh_terms: D001842:Bone and Bones / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006192:Haemophilus Infections / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D007902:Length of Stay; D008297:Male; D010019:Osteomyelitis / Q000000981:diagnostic imaging* / Q000628:therapy; D011379:Prognosis; D011877:Radionuclide Imaging; D012016:Reference Values; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000628:therapy; D014922:Wisconsin