Differentiating osteomyelitis from bone infarction in sickle cell disease.
This brief review discusses one possible approach to evaluating the sickle cell patient with bone pain. The major differential diagnoses include osteomyelitis and bone infarction. Based on previous studies, we provide an approach to assessing and treating patients with the possible diagnosis of osteomyelitis. An algorithm has been provided, which emphasizes the importance of the initial history and physical examination. Specific radiographic studies are recommended to aid in making the initial assessment and to determine whether the patient has an infarct or osteomyelitis. Differentiating osteomyelitis from infarction in sickle cell patients remains a challenge for the pediatrician. This algorithm can be used as a guide for physicians who evaluate such patients in the acute care setting.
Jules Stein Eye Institute, Department of Pediatrics, UCLA School of Medicine, Los Angeles, California, 90095-1752, USA.
A L
AL
Wong
K M
KM
Sakamoto
E E
EE
Johnson
D000208:Acute Disease; D000465:Algorithms; D000755:Anemia, Sickle Cell / Q000150:complications*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001842:Bone and Bones / Q000098:blood supply*; D003663:Decision Trees; D003937:Diagnosis, Differential; D004638:Emergency Treatment / Q000379:methods; D006801:Humans; D007238:Infarction / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008487:Medical History Taking / Q000379:methods; D008826:Microbial Sensitivity Tests; D010019:Osteomyelitis / Q000175:diagnosis* / Q000209:etiology* / Q000382:microbiology / Q000628:therapy; D010372:Pediatrics / Q000379:methods; D010808:Physical Examination / Q000379:methods; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents