Simone F C Knaap1. 1. Private practice, 9531 CM Borger, The Netherlands.
Abstract
OBJECTIVE: This study presents a case of a posttraumatic subacute osteomyelitis in a child with leg pain. CLINICAL FEATURES: A 10-year-old female gymnast with leg pain presented to a chiropractic clinic after having been treated over the previous year for a leg fracture. The patient had leg pain associated with prolonged use of her right leg, restlessness at night, and tenderness over the right tibia. The history did not suggest a mechanical cause of the patient's pain. All available radiographs were reviewed by the chiropractor; a diffuse lytic lesion with bone thickening and sclerosis was clearly visible in the area of the patient's chief complaint, representing a Brodie abscess. INTERVENTION AND OUTCOME: The doctor of chiropractic sent the patient back to the hospital. She was treated first with oral antibiotics, which were not successful. She underwent surgery and recovered well. CONCLUSION: Subacute osteomyelitis may have a diagnostic delay; thus, it is possible for a chiropractor to see this condition in the office. A good case history, examination, and radiographs are important for the diagnosis and to make a proper referral.
OBJECTIVE: This study presents a case of a posttraumatic subacute osteomyelitis in a child with leg pain. CLINICAL FEATURES: A 10-year-old female gymnast with leg pain presented to a chiropractic clinic after having been treated over the previous year for a leg fracture. The patient had leg pain associated with prolonged use of her right leg, restlessness at night, and tenderness over the right tibia. The history did not suggest a mechanical cause of the patient's pain. All available radiographs were reviewed by the chiropractor; a diffuse lytic lesion with bone thickening and sclerosis was clearly visible in the area of the patient's chief complaint, representing a Brodie abscess. INTERVENTION AND OUTCOME: The doctor of chiropractic sent the patient back to the hospital. She was treated first with oral antibiotics, which were not successful. She underwent surgery and recovered well. CONCLUSION: Subacute osteomyelitis may have a diagnostic delay; thus, it is possible for a chiropractor to see this condition in the office. A good case history, examination, and radiographs are important for the diagnosis and to make a proper referral.
Authors: Carlos Marin; Maria L Sanchez-Alegre; Carmen Gallego; Yolanda Ruiz; Estrella Collado; Jose A Garcia; Gloria G Mardones Journal: Curr Probl Diagn Radiol Date: 2004 Mar-Apr