ACUTE HEMATOGENOUS OSTEOMYELITIS IN CHILDREN IN FINLAND

The purpose of the study was to evaluate the history, clinical picture and diagnostic difficulties of acute haematogenous osteomyelitis (AHO M) in children. Forty-seven children under the age of 15 with bacterio logically proven AHOM were collected prospectively in Finland in 1981- 93. Staphylococcus aureus was responsible for 89% of the cases. The co mmonest sites affected were the tibia (25%) and the femur (23%) follow ed by the pelvis (15%) and the calcaneus (11%). Sites other than the l ong bones increased in frequency in children over the age of 4 years. Most of the children came with a history of a week or less with classi c signs and symptoms of AHOM, increased C-reactive protein (CRP) and e rythrocyte sedimentation rate (ESR) values but negative X-rays. Delay in hospital admission was observed in 19%. In 11% antimicrobial therap y was not instituted within 48 hours on ward. All children were clinic ally healthy at the 1-year check-up with minor X-ray changes seen in 1 1 patients. We conclude that children in Finland seek treatment early in the course of AHOM and have a good outcome. S.aureus is the main ae tiological agent affecting primarily the long bones, but in older chil dren pelvic and calcaneic sites are also frequent. No significant dela ys affecting the outcome were noticed in admittance to hospital or in the diagnosis of AHOM.