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Patella Osteomyelitis Mimicking Sinding-Larsen and Johansson Apophysitis: A Pitfall Not to Miss

BACKGROUND: Diagnosis of bony infection remains difficult during childhood. Osteomyelitis of the patella (OMP) is rare and produces few symptoms and no fever. A high level of suspicion is needed to avoid missing this uncommon type of bone infection. METHODS: / RESULTS: We report an acute osteomyelit...

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Autores principales: Traverso, Aurélien, Tschopp, Benjamin, Mekdade, Tristan, Kwiatkowski, Barbara, Lutz, Nicolas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7737432/
https://www.ncbi.nlm.nih.gov/pubmed/33354375
http://dx.doi.org/10.1155/2020/1780689
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author Traverso, Aurélien
Tschopp, Benjamin
Mekdade, Tristan
Kwiatkowski, Barbara
Lutz, Nicolas
author_facet Traverso, Aurélien
Tschopp, Benjamin
Mekdade, Tristan
Kwiatkowski, Barbara
Lutz, Nicolas
author_sort Traverso, Aurélien
collection PubMed
description BACKGROUND: Diagnosis of bony infection remains difficult during childhood. Osteomyelitis of the patella (OMP) is rare and produces few symptoms and no fever. A high level of suspicion is needed to avoid missing this uncommon type of bone infection. METHODS: / RESULTS: We report an acute osteomyelitis of the patella treated by joint and patella puncture aspiration followed by antibiotics in a 12-year-old healthy boy. Clinical and radiological findings, orthopedic follow-up, and clinical outcome are presented. CONCLUSION: Making a diagnosis of acute osteomyelitis of the patella can be challenging especially in the pediatric population, as it produces few specific symptoms with mostly nonspecific biologic anomalies. The paucity in specific signs and symptoms, accompanied by the rare occurrence, often leads to incorrect initial diagnosis, such as overuse injury or apophysitis. Clinical examination with high suspicion for patella infection is key. Radiological exams including MRI are the main components of the adequate imaging studies. Computed tomography may be an excellent addendum to better visualize any bony lesion within the patella. Bone aspiration or biopsy is essential to confirm the diagnosis and offers a first step in the treatment of this infection, which can then be successfully treated with a normal course of antibiotics.
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spelling pubmed-77374322020-12-21 Patella Osteomyelitis Mimicking Sinding-Larsen and Johansson Apophysitis: A Pitfall Not to Miss Traverso, Aurélien Tschopp, Benjamin Mekdade, Tristan Kwiatkowski, Barbara Lutz, Nicolas Case Rep Orthop Case Report BACKGROUND: Diagnosis of bony infection remains difficult during childhood. Osteomyelitis of the patella (OMP) is rare and produces few symptoms and no fever. A high level of suspicion is needed to avoid missing this uncommon type of bone infection. METHODS: / RESULTS: We report an acute osteomyelitis of the patella treated by joint and patella puncture aspiration followed by antibiotics in a 12-year-old healthy boy. Clinical and radiological findings, orthopedic follow-up, and clinical outcome are presented. CONCLUSION: Making a diagnosis of acute osteomyelitis of the patella can be challenging especially in the pediatric population, as it produces few specific symptoms with mostly nonspecific biologic anomalies. The paucity in specific signs and symptoms, accompanied by the rare occurrence, often leads to incorrect initial diagnosis, such as overuse injury or apophysitis. Clinical examination with high suspicion for patella infection is key. Radiological exams including MRI are the main components of the adequate imaging studies. Computed tomography may be an excellent addendum to better visualize any bony lesion within the patella. Bone aspiration or biopsy is essential to confirm the diagnosis and offers a first step in the treatment of this infection, which can then be successfully treated with a normal course of antibiotics. Hindawi 2020-12-07 /pmc/articles/PMC7737432/ /pubmed/33354375 http://dx.doi.org/10.1155/2020/1780689 Text en Copyright © 2020 Aurélien Traverso et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Traverso, Aurélien
Tschopp, Benjamin
Mekdade, Tristan
Kwiatkowski, Barbara
Lutz, Nicolas
Patella Osteomyelitis Mimicking Sinding-Larsen and Johansson Apophysitis: A Pitfall Not to Miss
title Patella Osteomyelitis Mimicking Sinding-Larsen and Johansson Apophysitis: A Pitfall Not to Miss
title_full Patella Osteomyelitis Mimicking Sinding-Larsen and Johansson Apophysitis: A Pitfall Not to Miss
title_fullStr Patella Osteomyelitis Mimicking Sinding-Larsen and Johansson Apophysitis: A Pitfall Not to Miss
title_full_unstemmed Patella Osteomyelitis Mimicking Sinding-Larsen and Johansson Apophysitis: A Pitfall Not to Miss
title_short Patella Osteomyelitis Mimicking Sinding-Larsen and Johansson Apophysitis: A Pitfall Not to Miss
title_sort patella osteomyelitis mimicking sinding-larsen and johansson apophysitis: a pitfall not to miss
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7737432/
https://www.ncbi.nlm.nih.gov/pubmed/33354375
http://dx.doi.org/10.1155/2020/1780689
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