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 osteomyelitis...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2020/1780689 |
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| author | Aurélien Traverso Benjamin Tschopp Tristan Mekdade Barbara Kwiatkowski Nicolas Lutz |
| author_facet | Aurélien Traverso Benjamin Tschopp Tristan Mekdade Barbara Kwiatkowski Nicolas Lutz |
| author_sort | Aurélien Traverso |
| collection | DOAJ |
| 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. |
| format | Article |
| id | doaj-art-01ac835fe4af4e0b80cdc8826e5f6e25 |
| institution | DOAJ |
| issn | 2090-6749 2090-6757 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Orthopedics |
| spelling | doaj-art-01ac835fe4af4e0b80cdc8826e5f6e252025-08-20T03:22:29ZengWileyCase Reports in Orthopedics2090-67492090-67572020-01-01202010.1155/2020/17806891780689Patella Osteomyelitis Mimicking Sinding-Larsen and Johansson Apophysitis: A Pitfall Not to MissAurélien Traverso0Benjamin Tschopp1Tristan Mekdade2Barbara Kwiatkowski3Nicolas Lutz4Department of Pediatric and Adolescent Surgery, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, SwitzerlandDepartment of Pediatric and Adolescent Surgery, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, SwitzerlandDepartment of Pediatric and Adolescent Surgery, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, SwitzerlandDepartment of Pediatric and Adolescent Surgery, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, SwitzerlandDepartment of Pediatric and Adolescent Surgery, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, SwitzerlandBackground. 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.http://dx.doi.org/10.1155/2020/1780689 |
| spellingShingle | Aurélien Traverso Benjamin Tschopp Tristan Mekdade Barbara Kwiatkowski Nicolas Lutz Patella Osteomyelitis Mimicking Sinding-Larsen and Johansson Apophysitis: A Pitfall Not to Miss Case Reports in Orthopedics |
| 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 |
| url | http://dx.doi.org/10.1155/2020/1780689 |
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