Osteomyelitis – Beyond Neonatal To 18 Months

  • Etiology: infectious
  • Imaging: metaphysis is most common location of infection due to slow blood flow, before epiphyseal ossification centers appear (18 months) infection can cross growth plate into epiphysis, continuous periosteal reaction, deep soft tissue edema

Cases of Osteomyelitis – Beyond Neonatal To 18 Months

Radiograph of osteomyelitis beyond neonatal to 18 months
AP (left) and lateral radiographs (right) of the elbow show extensive periosteal reaction of the distal humerus and proximal ulna and an effusion of the elbow joint.
Radiograph of osteomyelitis beyond neonatal to 18 months
AP radiograph of the elbow shows a lucent destructive lesion in the distal ulna without periosteal reaction.
Radiograph of osteomyelitis beyond neonatal to 18 months
CXR at presentation (above) is unremarkable. AP radiograph of the left shoulder obtained 5 days later (below) shows displacement and destruction of the epiphysis of the proximal humerus.
Radiograph of osteomyelitis with Brodie's abscess
AP radiograph of the knee at presentation (upper left) shows lucent lesions of the metaphysis and epiphysis which show some interval healing on a followup AP radiograph of the knee taken 2 months later (upper right). The patient was lost to followup and did not complete antibiotic therapy and returned to clinic 2 years later and the AP radiograph at that time (lower left) shows a lucent sinus tract extending from the epiphysis to the metaphysis that persists on the next AP radiograph of the knee obtained 1 year later (lower right).