title: MRI of acute osteomyelitis in long bones of children: Pathophysiology study.
abstract: The classic pathophysiology of acute osteomyelitis in children described by Trueta has a metaphyseal infection as the starting point. This hypothesis was recently brought into question by Labbé's study, which suggested a periosteal origin. Thus, we wanted to study this disease's pathophysiology through early MRI examinations and to look for prognostic factors based on abnormal findings.
  
  
  
  This was a prospective, multicentre study that included cases of long bone osteomyelitis in children who underwent an MRI examination within 7days of the start of symptoms and within 24hours of the initiation of antibiotic therapy. We also collected clinical, laboratory and treatment-related data.
  
  
  
  Twenty patients were included, including one with a bifocal condition. The lower limb was involved in most cases (19/21). Staphylococcus aureus was found most frequently. Metaphyseal involvement was present in all cases. No isolated periosteal involvement was found in any of the cases. No prognostic factors were identified based on the various abnormal findings on MRI.
  
  
  
  Our study supports the metaphyseal origin of acute osteomyelitis in children.
  
  
  
  II.
authors.affiliation: Service d'orthopédie pédiatrique, hôpital des Enfants, Toulouse, France. Electronic address: camille.theveninlemoine@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Thévenin-Lemoine
authors.affiliation: Service d'imagerie médicale pédiatrique, hôpital des Enfants, Toulouse, France.
authors.forename: J
authors.initials: J
authors.lastname: Vial
authors.affiliation: Service de chirurgie orthopédique, centre hospitalier térritorial de Nouvelle Calédonie, Nouméa, New Caledonia.
authors.forename: J L
authors.initials: JL
authors.lastname: Labbé
authors.affiliation: Service d'épidémiologie médicale, hôpital Purpan, Toulouse, France.
authors.forename: B
authors.initials: B
authors.lastname: Lepage
authors.affiliation: Service d'orthopédie pédiatrique, hôpital Robert-Debré, Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Ilharreborde
authors.affiliation: Service d'orthopédie pédiatrique, hôpital des Enfants, Toulouse, France.
authors.forename: F
authors.initials: F
authors.lastname: Accadbled
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D010019:Osteomyelitis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology*; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents
keywords: Acute osteomyelitis; Child; MRI