Pediatric subacute osteomyelitis
Introduction
Introduction to subacute osteomyelitis in children Subacute osteomyelitis is a localized bone infection caused by low-virulence bacteria. It is characterized by insidious onset, mild local symptoms, and no systemic symptoms such as fever. basic knowledge The proportion of illness: 0.001% Susceptible people: children Mode of infection: non-infectious Complications: bone tumor
Cause
The cause of subacute osteomyelitis in children
(1) Causes of the disease
Most scholars believe that due to the widespread use of antibiotics, the virulence of bacteria is reduced, or the patient's resistance is enhanced. The bacteria that enter the bone through the circulation of blood, only produce a localized inflammatory reaction, forming a localized abscess and bone tissue destruction.
(two) pathogenesis
There is obvious osteogenic reaction around the lesion. The center of the lesion may be pus or granulation tissue. When the cortical bone is worn, the periosteum is stimulated to proliferate, resulting in new bone, ie periosteal reaction.
Prevention
Prevention of subacute osteomyelitis in children
Mostly caused by blood line dissemination or infection, it should be actively prevented to treat sepsis. Actively prevent skin, mucous membranes, various infectious diseases, upper respiratory tract infections, etc.
Complication
Pediatric subacute osteomyelitis complications Complications
The course of the disease is prolonged, and the destruction of the bone tissue is formed, and the vertebrae collapse can occur.
Symptom
Subacute myeloinflammatory symptoms in children Common symptoms Soft tissue swelling Loss of appetite
Usually the patient has only partial mild pain and discomfort, soft tissue swelling is not obvious, no fever, loss of appetite and other systemic reactions, physical examination can find local mild, moderate deep tenderness, sometimes mild swelling of soft tissue, but no skin Increased temperature and superficial vein dilatation.
Examine
Examination of subacute osteomyelitis in children
1. Blood examination: The white blood cell and neutrophil counts are normal, and the amount of hemoglobin may be reduced.
2. Blood test: ESR tends to increase.
3. Pathogen examination: The positive rate of bacterial culture in lesion tissue is about 60%.
X-ray examination is of great significance for the diagnosis of this disease. Because of the different lesions, the shape of the lesion and the surrounding tissue, the X-ray findings are also very different. Roberts et al. divided it into six types and it has been generally accepted.
1. Type I: For the central lesion of the long bone metaphysis, a translucent area of varying sizes can be seen, sometimes with a bone sclerosis reaction. This type of lesion was previously called a Brodie abscess.
2. Type II: It is also a lesion that occurs in the metaphysis. It is characterized by the spread of the abscess in the medullary cavity to one side of the cortex, which destroys the cortical bone and develops along the longitudinal axis. It has similar performance to osteosarcoma.
3. Type III: bone destruction in the main part of the bone, accompanied by thickening of the cortex and periosteal reaction.
4. Type IV: It is also a localized bone destruction in the backbone, and there is a pericarp-like periosteal reaction, which needs to be differentiated from the early Ewing tumor.
5.V type: the central bone destruction of the epiphysis.
6. Type VI: There is a density reduction zone in the center of the vertebral body with clear boundaries, often accompanied by vertebral collapse.
Diagnosis
Diagnosis and diagnosis of subacute osteomyelitis in children
The diagnosis of this disease still has certain difficulties, often misdiagnosed as malignant or benign tumors, and the diagnosis depends mainly on pathological examination and bacterial culture of the lesion tissue.
Attention should be paid to the identification of early Ewing tumors and other bone tumors.
