PELVIC MUSCULOSKELETAL INFECTION IN INFANTS - DIAGNOSTIC DIFFICULTIESAND RADIOLOGICAL FEATURES

Musculoskeletal infection involving the pelvis has rarely been reporte d in infants, When such infections involve the pelvic muscles they are generally believed to result from secondary spread from adjacent stru ctures, We report five cases of primary pelvic musculoskeletal infecti on affecting infants <1 year, all of which presented during a 1-year p eriod, In two patients the infection appeared to arise primarily in mu scle, Clinical features were generally non-specific and often misleadi ng, mimicking hip (4/5) or vascular (3/5) pathology; as a result, diag nosis was delayed in four patients, Radiological investigation was req uired to make the diagnosis and delineate the extent of the lesion in all cases, Magnetic resonance imaging (MRI) was the most useful imagin g technique, accurately identifying the infection and its extent in al l cases in which it was used, However, plain films, ultrasound (US), s cintigraphy and computed tomography (CT) were all useful in individual cases and have a role in the primary investigation of these difficult infections, The clinical presentation of pelvic musculoskeletal infec tion in infants and the role of the various radiological investigation s in its diagnosis is discussed.