Primary subacute epiphyseal osteomyelitis.

In eight children with primary subacute osteomyelitis of a femoral or tibial epiphysis, the only complaints were pain and limp. Plain roentgenograms and tomograms showed a well defined lytic lesion in the epiphysis and no evidence of any connection to the metaphysis. Although the bone of the epiphysis was involved in every instance, and the lesion extended to the articular cartilage in most patients, the cartilage itself was not damaged. When the lesions were curetted, six were sterile on routine and anaerobic cultures and on culture for tuberculous and fungal organisms, and Staphylococcus was grown from the other two. In every case the curetted tissue had the characteristic histological appearence of osteomyelitis. All patients were treated with oxacillin and recovered completely. Postoperative roentgenograms showed complete healing with no evidence of damage to the physis or the joint after follow-up of two to eight years.