MR Evaluation of Pyo genic Osteomyelitis Involving the Epiphyses

PURPOSE: The purpose of this study was to analyze of the MR findings of the pyogenic osteomyelitis involving the epiphyses of the long bones in childhood. MATERIALS AND METHODS: Eleven childen with pyogenic osteomyelitis involving the epiphyses of the long bones were evaluated by MRI. A diagnosis of pyogenic osteomyelitis was established by biopsy and culture in eight cases and during follow-up after antibiotic treatment in three. We analyzed the involved bone, initial location, pattern, degree of growth plate involvement, degree of epiphyseal involvement, surrounding change and plain radiographic findings. RESULTS: The involved bones were the proximal femur in four cases, distal femur in two, proximal tibia in two, distal tibia in one, distal fibula in one and proximal humerus in one. The initial site of the lesion was the metaphysis in ten cases and epiphysis in one. The lesion pattern was the Brodie's abscess in six cases and osteomyelitis in five. The degree of growth plate involvement was 16-20% in five case and 5% or less in four ; the degree of epiphyseal involvement was 5% or less in four cases, 6-10% in four and 11-15% in two. All cases showed low or intermediate signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and contrast enhancement. Joint effusion adjacent to the lesion was detected in five cases. Radiographic findings of the involved epiphysis were normal in six cases, but indicated osteolytic lesion in four cases and sclerosis in one. CONCLUSION: Pyogenic osteomyelitis involving the epiphyses of the long bones in childhood usually developed from metaphyseal osteomyelitis and was combined with destruction of the growth plate.

MR Evaluation of Pyo genic Osteomyelitis Involving the Epiphyses

PURPOSE: The purpose of this study was to analyze of the MR findings of the pyogenic osteomyelitis involving the epiphyses of the long bones in childhood. MATERIALS AND METHODS: Eleven childen with pyogenic osteomyelitis involving the epiphyses of the long bones were evaluated by MRI. A diagnosis of pyogenic osteomyelitis was established by biopsy and culture in eight cases and during follow-up after antibiotic treatment in three. We analyzed the involved bone, initial location, pattern, degree of growth plate involvement, degree of epiphyseal involvement, surrounding change and plain radiographic findings. RESULTS: The involved bones were the proximal femur in four cases, distal femur in two, proximal tibia in two, distal tibia in one, distal fibula in one and proximal humerus in one. The initial site of the lesion was the metaphysis in ten cases and epiphysis in one. The lesion pattern was the Brodie's abscess in six cases and osteomyelitis in five. The degree of growth plate involvement was 16-20% in five case and 5% or less in four ; the degree of epiphyseal involvement was 5% or less in four cases, 6-10% in four and 11-15% in two. All cases showed low or intermediate signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and contrast enhancement. Joint effusion adjacent to the lesion was detected in five cases. Radiographic findings of the involved epiphysis were normal in six cases, but indicated osteolytic lesion in four cases and sclerosis in one. CONCLUSION: Pyogenic osteomyelitis involving the epiphyses of the long bones in childhood usually developed from metaphyseal osteomyelitis and was combined with destruction of the growth plate.

Incidence of the Appearance of the Proximal Humeral Ossification Center of the Neonates and Infants on Plain Chest Radiograph

PURPOSE: To ascertain the incidence of proximal humeral epiphyseal ossification centers, as shown on chest radiographs, in neonates and infants. MATERIALS AND METHODS: The distribution of corrected age(CA) of the infantswas from 24 weeks of gestational age to 6 months of postnatal age. They were obtained from inborn and outborn infants without developmental problems. Proximal humeral epiphyseal ossification centers were evaluated by two radiologists from a total of 440 chest radiographs. Of these, 196 were of the female chest and 244 were of themale. Corrected ages based on postnatal age are expressed as weeks before two months of age and as months after two months of age. The ossified or nonossified epiphyses of the humeral heads were plotted against corrected age. From these graphs, the percentages of ossification according to their corrected age was observed. RESULTS: 37weeks of corrected age in which 9.1%(1/11) was ossified was the earliest age of humeral epiphyseal ossification in the female. While 35 weeks of CA in which 6.3%(1/16) was ossified was the earliest age in the male. In full-term neonates(=40 weeks of CA), 20%(6/30) of epiphysis was ossified in the female and 23.3%(7/30) in the male. The female group of 43-44 weeks of corrected age showed ossification of 50% and the male group of 44-45 weeks of corrected age showed ossification of 50%. By five months of corrected age, 100% of epiphyses, both in the female and in the male, were ossified. CONCLUSION: Humeral ossification centers are seen from 35-37 weeks of correctedage. By five months of age, all humeral epiphyses are ossified.