ACUTE HEMATOGENOUS OSTEOMYELITIS IN CHILD HOOD - CORRELATION BETWEEN CLINICAL SIGNS, DIAGNOSTIC PARAMETERS, TREATMENT AND PROGNOSIS

Background Acute hematogenous osteomyelitis is a common disease in chi ldhood. If treated early, conservative management is possible in most cases. During recent decades, clinical picture, diagnostic techniques and treatment have changed due to various reasons, e.g. previous antib iotic treatment. New laboratory tests and improved imaging techniques such as magnetic resonance imaging enable an earlier diagnosis and thu s an earlier onset of treatment and improve the prognosis of hematogen ous osteomyelitis. Outcome has also been improved by new antibiotics w ith enhanced activity against staphylococci. Method The records of 34 children aged 3 weeks to 172 months with acute hematogenous osteomyeli tis were evaluated retrospectively. In some cases, the data were compl eted by phone calls with parents and family physicians. The results we re compared with the current literature. Results and Conclusions If di agnosed and treated early, acute hematogenous osteomyelitis in childho od has a good prognosis. For primary diagnosis, the clinical picture, parameters of inflammation and magnetic resonance imaging or scintigra phy are useful. The course of the disease can be assessed by clinical signs and the erythrocyte sedimentation rate. Complications can be rec ognized by conventional radiography and sonography. Initial antibiotic treatment should be carried out parenterally for at least 3 weeks. An exclusively oral treatment is not recommended.