Patella Osteomyelitis Mimicking Sinding-Larsen and Johansson Apophysitis: A Pitfall Not to Miss.
Journal
Case reports in orthopedics
ISSN: 2090-6749
Titre abrégé: Case Rep Orthop
Pays: United States
ID NLM: 101591806
Informations de publication
Date de publication:
2020
2020
Historique:
received:
09
03
2020
revised:
12
10
2020
accepted:
26
11
2020
entrez:
23
12
2020
pubmed:
24
12
2020
medline:
24
12
2020
Statut:
epublish
Résumé
Diagnosis of bony infection remains difficult during childhood. Osteomyelitis of the patella (OMP) is rare and produces few symptoms and no fever. A high level of suspicion is needed to avoid missing this uncommon type of bone infection. /. We report an acute osteomyelitis of the patella treated by joint and patella puncture aspiration followed by antibiotics in a 12-year-old healthy boy. Clinical and radiological findings, orthopedic follow-up, and clinical outcome are presented. Making a diagnosis of acute osteomyelitis of the patella can be challenging especially in the pediatric population, as it produces few specific symptoms with mostly nonspecific biologic anomalies. The paucity in specific signs and symptoms, accompanied by the rare occurrence, often leads to incorrect initial diagnosis, such as overuse injury or apophysitis. Clinical examination with high suspicion for patella infection is key. Radiological exams including MRI are the main components of the adequate imaging studies. Computed tomography may be an excellent addendum to better visualize any bony lesion within the patella. Bone aspiration or biopsy is essential to confirm the diagnosis and offers a first step in the treatment of this infection, which can then be successfully treated with a normal course of antibiotics.
Sections du résumé
BACKGROUND
BACKGROUND
Diagnosis of bony infection remains difficult during childhood. Osteomyelitis of the patella (OMP) is rare and produces few symptoms and no fever. A high level of suspicion is needed to avoid missing this uncommon type of bone infection.
METHODS
METHODS
/.
RESULTS
RESULTS
We report an acute osteomyelitis of the patella treated by joint and patella puncture aspiration followed by antibiotics in a 12-year-old healthy boy. Clinical and radiological findings, orthopedic follow-up, and clinical outcome are presented.
CONCLUSION
CONCLUSIONS
Making a diagnosis of acute osteomyelitis of the patella can be challenging especially in the pediatric population, as it produces few specific symptoms with mostly nonspecific biologic anomalies. The paucity in specific signs and symptoms, accompanied by the rare occurrence, often leads to incorrect initial diagnosis, such as overuse injury or apophysitis. Clinical examination with high suspicion for patella infection is key. Radiological exams including MRI are the main components of the adequate imaging studies. Computed tomography may be an excellent addendum to better visualize any bony lesion within the patella. Bone aspiration or biopsy is essential to confirm the diagnosis and offers a first step in the treatment of this infection, which can then be successfully treated with a normal course of antibiotics.
Identifiants
pubmed: 33354375
doi: 10.1155/2020/1780689
pmc: PMC7737432
doi:
Types de publication
Case Reports
Langues
eng
Pagination
1780689Informations de copyright
Copyright © 2020 Aurélien Traverso et al.
Déclaration de conflit d'intérêts
The authors declare that they have no conflicts of interest.
Références
Knee. 2007 Aug;14(4):333-5
pubmed: 17566741
BMJ Case Rep. 2014 Oct 15;2014:
pubmed: 25320263
J Pediatr Orthop. 1991 May-Jun;11(3):364-6
pubmed: 2056086
J Bone Joint Surg Br. 2001 Jan;83(1):99-102
pubmed: 11245548
Clin Orthop Relat Res. 1978 May;(132):177-9
pubmed: 679536
World J Surg Oncol. 2015 Apr 25;13:163
pubmed: 25906772
Postgrad Med J. 2000 Nov;76(901):707-9
pubmed: 11060146
Case Rep Orthop. 2017;2017:6573271
pubmed: 28484657
Quant Imaging Med Surg. 2016 Apr;6(2):184-98
pubmed: 27190771
Acta Orthop Scand. 1976 Oct;47(5):566-9
pubmed: 998194
J Pediatr Orthop B. 2012 Sep;21(5):411-4
pubmed: 21694640
Clin Orthop Relat Res. 1986 Jul;(208):119-25
pubmed: 3522019
Phys Sportsmed. 2008 Dec;36(1):nihpa116823
pubmed: 19652694
Am J Dis Child. 1967 May;113(5):590-3
pubmed: 6024233
J Bone Joint Surg Br. 2012 May;94(5):584-95
pubmed: 22529075
Clin Orthop Relat Res. 2001 Aug;(389):30-4
pubmed: 11501819