Osteomyelitis infection disguised as Reiter’s Syndrome in a child: A case report

This is a case of a 16-year-old African boy with Osteomyelitis presenting with symptoms of reactive arthritis (Reiter’s syndrome) KEYWORDS Osteomyelitis, Reiter’s syndrome, Fever, Bone pain, Erythema, Ewing sarcoma

A Case Report of Osteomyelitis of Lower End of Tibia and Fibula as a Complication of Elastic Rubber Band Syndrome (Dhaga Syndrome)

Introduction: Rubber band syndrome is a rare acquired condition poorly discussed in literature, when neglected can lead to devastating complications of compartment syndrome and infection of soft tissue and bone as seen in the present case. Rubber band or Dhaga (sacred thread) when worn for prolonged duration can bury into the skin and soft tissue. Case Report: A 12-month-old girl developed osteomyelitis of tibia and fibula as sequelae of misdiagnosis and treatment for this syndrome. Assuming it to be a simple constriction band, incisions were given on medial and lateral aspect of the ankle, later she developed osteomyelitis of the tibia and fibula with in buried rubber band, which was removed and thorough curettage done and achieved good healing of the bones. Conclusion: Rubber band syndrome in not an uncommon condition, but when neglected or misdiagnosed can lead to complications such as compartment syndrome and osteomyelitis of the bones in involved limb as seen in this case. In suspected cases, imaging with sonography and X-ray of involved helps in diagnosis. Keywords: Osteomyelitis, rubber band syndrome, Dhaga syndrome, compartment syndrome.

On the issue of complex diagnostic radiology of inflammatory bone diseases in children at an early stage

Aim: to study the possibilities of diagnostic radiology methods for changes in metaphyses and epiphyses at an early stage of the inflammatory process in children aged 1 and older and adolescents. Patients and Methods: 76 emergency patients with a diagnosis of acute metaepiphysial hematogenous osteomyelitis were examined using standard radiography (SR), ultrasonography (US), magnetic resonance imaging (MRI) and computed tomography (CT). The age of the patients ranged from 1 to 18 years. All patients in the admission department underwent US and SR with a mandatory examination of the contralateral region. After analyzing the obtained data, additional examination algorithms were formed using MRI and CT. Results and Discussion: US of the targeted area was descriptive concerning the soft tissue pathological component: paraosseous soft tissues edema was determined in 75%, structural changes of the joint, in particular, synovitis — in 78.9%, joint effusion — in 57.9%. X-ray examination had a limited opportunity to detect destructive changes in bone tissue at the early stages of the pathological process (6.6%). At the same time, MRI revealed the maximum number of semiotic signs of acute hematogenous osteomyelitis, the most significant of which were: trabecular bone marrow edema (100%), periosteal changes (96.1%) and extraosseous changes (98.5%). CT was performed in 26 patients with multifocal disease, as well as in the late stage of the inflammatory process for preoperative planning. Bone destruction at an early stage occurred in 32.7% of patients, a change in the growth area — in 81.0 % of cases. Along with these semiotic signs, sequesters (55.3 %) and fistula tracts (31.3%) were visualized. Conclusion: the obtained results made it possible to systematize information on the diagnostic radiology efficacy for acute metaphyseal and epiphyseal lesions in the early stage of the inflammatory process in children aged 1 and older and adolescents. KEYWORDS: osteomyelitis, epiphysis, metaphysis, diagnostic radiology, pediatrics. FOR CITATION: Sholokhova N.A., Olkhova E.B. On the issue of complex diagnostic radiology of inflammatory bone diseases in children at an early stage. Russian Medical Inquiry. 2021;5(5):330–334 (in Russ.). DOI: 10.32364/2587-6821-2021-5-5-330-334.