BACKGROUND: K. kingae is a common causative organism in acute osteoarticular infections (OAIs) in children under 4 years of age. Differentiation between K. kingae and Gram-positive cocci (GPC) is of great interest therapeutically. OBJECTIVE: Our aim was to identify early distinguishing MRI features of OAIs. MATERIALS AND METHODS: Thirty-one children younger than 4 years of age with OAI underwent MRI at presentation. Of these, 21 were caused by K. kingae and ten by GPC. Bone and soft tissue reaction, epiphyseal cartilage involvement, bone and subperiosteal abscess formation were compared between the two groups. Interobserver agreement was measured. RESULTS: Bone reaction was less frequent (P = 0.0066) and soft tissue reaction less severe (P = 0.0087) in the K. kingae group. Epiphysis cartilage abscesses were present only in the K. kingae group (P = 0.0118). No difference was found for bone abscess (P = 0.1411), subperiosteal abscess (P = 1) or joint effusion (P = 0.4414). Interobserver agreement was good for all criteria. CONCLUSION: MRI is useful in differentiating K. kingae from GPC in OAI. Cartilaginous involvement and modest soft tissue and bone reaction suggest K. kingae.
BACKGROUND:K. kingae is a common causative organism in acute osteoarticular infections (OAIs) in children under 4 years of age. Differentiation between K. kingae and Gram-positive cocci (GPC) is of great interest therapeutically. OBJECTIVE: Our aim was to identify early distinguishing MRI features of OAIs. MATERIALS AND METHODS: Thirty-one children younger than 4 years of age with OAI underwent MRI at presentation. Of these, 21 were caused by K. kingae and ten by GPC. Bone and soft tissue reaction, epiphyseal cartilage involvement, bone and subperiosteal abscess formation were compared between the two groups. Interobserver agreement was measured. RESULTS: Bone reaction was less frequent (P = 0.0066) and soft tissue reaction less severe (P = 0.0087) in the K. kingae group. Epiphysis cartilage abscesses were present only in the K. kingae group (P = 0.0118). No difference was found for bone abscess (P = 0.1411), subperiosteal abscess (P = 1) or joint effusion (P = 0.4414). Interobserver agreement was good for all criteria. CONCLUSION: MRI is useful in differentiating K. kingae from GPC in OAI. Cartilaginous involvement and modest soft tissue and bone reaction suggest K. kingae.
Authors: Paul Maxwell Courtney; John M Flynn; Diego Jaramillo; Bernard David Horn; Kristen Calabro; David A Spiegel Journal: J Pediatr Orthop Date: 2010-12 Impact factor: 2.324
Authors: Kit M Song; Karl Craig Boatright; Jeff Drassler; Mark S Strom; William B Nilsson; Wesley Bevan; Jane L Burns Journal: J Pediatr Orthop Date: 2009-03 Impact factor: 2.324
Authors: Kyu-Sung Kwack; Jae Hyun Cho; Jei Hee Lee; Jae Ho Cho; Ki Keun Oh; Sun Yong Kim Journal: AJR Am J Roentgenol Date: 2007-08 Impact factor: 3.959