Pseudomonas osteomyelitis of the talus: review of the pathophysiology and report of a rare case.

UNLABELLED: Hematogenous Pseudomonas aeruginosa osteomyelitis of the talus is a rare cause of ankle swelling and limping in children. The case presented herein is that of chronic osteomyelitis of the talus with sequestrum formation. The patient was successfully treated with sequestrectomy and curettage, immobilization, and antibiotic therapy. One year following the operation, the patient displayed mild restriction of ankle dorsiflexion, without evidence of inflammation or arthritis, and radiographs revealed remodeling of the talar neck with increased radiographic density at the site of sequestrectomy. There was no evidence of avascular necrosis or disturbance of the growth of the talus. Although rare, osteomyelitis of the talus should be considered in children and adolescents who present with ankle swelling and an antalgic gait. LEVEL OF CLINICAL EVIDENCE: 4.