T. Spindler et al., ACUTE HEMATOGENOUS OSTEOMYELITIS IN CHILD HOOD - CORRELATION BETWEEN CLINICAL SIGNS, DIAGNOSTIC PARAMETERS, TREATMENT AND PROGNOSIS, Klinische Padiatrie, 210(2), 1998, pp. 56-60
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.