Pyogenic osteomyelitis of the vertebral arch in children.
Vertebral infection represents 2% to 4% of all cases of osteomyelitis in children. Extension of vertebral osteomyelitis into the vertebral arch is rare; and exclusive pyogenic involvement is exceedingly rare, especially in children. A review of the literature revealed less than 25 combined cases, most of them reported in the beginning of the 20th century without cross-sectional imaging. The unusual location creates difficulties in distinguishing vertebral osteomyelitis from neoplasm and arthritic conditions. We present 2 cases of infection of the posterior vertebral elements. Most useful in identifying the presence and extent of infection were a sudden onset of nonspecific back pain, elevated inflammatory parameters, and magnetic resonance imaging. Antibiotic therapy with or without surgical intervention provided successful management. With the recurrence observed in 1 child, the most optimal treatment of this condition might still be unknown.
Reiss-Zimmermann
Martin
M
University Hospital Leipzig, Department of Pediatric Radiology, Liebigstr. 20a, 04103 Leipzig, Germany. martin.reiss-zimmermann@medizin.uni-leipzig.de
Hirsch
Wolfgang
W
Schuster
Volker
V
Wojan
Magdalena
M
Sorge
Ina
I
D000293:Adolescent; D001855:Bone Marrow Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D002444:Cefuroxime / Q000627:therapeutic use; D002648:Child; D002981:Clindamycin / Q000627:therapeutic use; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D010019:Osteomyelitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D011300:Preoperative Care / Q000379:methods; D013122:Spinal Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging / Q000188:drug therapy; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
D002981:Clindamycin; D002444:Cefuroxime