Vertebral Langerhans cell histiocytosis in childhood - A differential diagnosis of spinal osteomyelitis

Background: The Langerhans cell histiocytosis has lots of different manifes tations. Symptoms are not specific enough to identify the disease. In cases of vertebral Langerhans cell histiocytosis it is sometimes difficult to di fferentiate the lesions from spinal osteomyelitis. Patients: Six children with Langerhans cell histiocytosis who had an operat ive treatment at our clinic in 1981 to 1995 have been reviewed. All patient s had a localised vertebral presentation at the onset of the disease. Methods: In this study we have been showed the clinical, radiological, hist ological and laboratory findings of our patients with Langerhans cell histi ocytosis for an average of six years. Especially the use of diagnostic tool s has been examined. Results: Diagnostic tools such as radiogram, computerised tomography, bone scan and MRI and their value in finding the correct diagnosis have been des cribed. Especially the use of MRI in early diagnosing has been discussed. E arly changes in MRI have been presented as well as the useful radiological signs and MRI signs to differentiate Langerhans cell histiocytosis and spin al osteomyelitis. Conclusions: Vertebral Langerhans cell histiocytosis in childhood is a poss ible differential diagnosis to spinal osteomyelitis.