Acute Pyogenic Osteomyelitis in Innominate Bones Simulating Septic Hip in Children: A Report of Seven Cases / 대한정형외과학회잡지

ABSTRACT

Acute hematogenous osteomyelitis adjacent to hip, though uncommon, should be included in the differential diagnosis of the patients presenting symptoms suggestive of septic arthritis of hip. When it occurs in children, it is particularly serious, because the diagnosis at first may be very difficult to be made. Our observations on seven cases reported here suggest the following findings to be helpful for early differential diagnosis of osteomyelitis of innominate bones from septic hip. 1. Among 7 cases, 4 had lesions in ischium, and 3 in os ilii. 2. The initial diagnosis on admission in 3 cases out of 7 was wrongly made to be septic arthritis of hip. 3. Early accurate diagnosis is essential to initiate early treatment, and there by shortens the convalescent time and minimize sequelae. 4. The diagnosis could be made in the cases by clinical and roentgenographic findings, such as fever, pain nature, antalgic posture of hip together with range of hip motion, tender point around hip and positive soft tissue and bony X-ray findings, but K-ray taken on early stage of infection could not provide any clue until bone lesion appears. 5. Gentle passive motion of hip is more easily permitted without eliciting severe pain and restriction of motion in the infection of innominate bone than in the septic hip. This also can be another clue to differentiate the acute osteomyelitis of innominate bone from septic arthritis of the hip.