No abstract available.
Osteomyelitis

No abstract available.
Osteomyelitis*

No abstract available.
Osteomyelitis*

OBJECTIVE: This study aimed to evaluate the inter- and intraobserver reliability of the Penny and Beit CURE radiologic classifications of pediatric patients with Chronic Hematogenous Osteomyelitis (CHOM) in the Philippine General Hospital (PGH). METHODS: Thirty-four pre-operative radiographs of PGH pediatric patients with CHOM were classified by seven orthopedic surgeons using both Penny and Beit CURE Classification systems. Two sets of radiographs were sent to the surgeons twice, four weeks apart, to classify. The Fleiss and Cohen κ statistics were used to determine inter- and intraobserver reliabilities, respectively. RESULTS: The Penny Classification had a slight to fair interobserver reliability (Fleiss κ = 0.17 and 0.24) and a fair intraobserver reliability (Cohen κ =0.35) with a 49.58% average intraobserver agreement. The interobserver reliability when including all Beit CURE classification subtypes was fair (κ = 0.28 and 0.31). This improved to moderate (κ = 0.41 and 0.54) when using only the four main types of the Beit CURE classification with a 77.31% intraobserver agreement. CONCLUSION: The Beit CURE classification for pediatric CHOM had higher inter- and intraobserver agreement rates than the Penny classification. Further improvement in reliability can be made by combining B2 and B3 subtypes under the Beit CURE classification.
Osteomyelitis

Introduction: Imaging modality has become increasingly important in hospital setting especially in cases of unknown site of infection/pyrexia of unknown origin (PUO) and osteomyelitis (OM). In recent years, nuclear imaging has been used and is known to deliver prompt and precise diagnoses of numerous infectious diseases. The purpose of the study is to detect and localise the site of infection using Tc99m-besilesomab and to assess the added contributions of single photon emission computed tomography/computed tomography (SPECT/CT) over planar scan in patients with PUO and OM. Methods: Tc99m-besilesomab with SPECT/CT were prospectively performed in 23 patients (eight males, 15 females) with suspected infection. True findings were diagnosed by both cold and hot spot in the scan with reference to positive blood or tissue cultures, or other additional imaging. Results: Tc99m-besilesomab managed to detect presence of infection with high sensitivity of 87.5% and specificity of 71.4%. Interobserver variability agreement that was obtained between the presence of infection and the ability of Tc99m-besilesomab imaging to detect it was significant (p<0.05), Kappa=0.7. SPECT/CT has increased the detection sensitivity by 6.3% and specificity by 28.6%. Out of 23 patients, 15 had true positive, seven had true negative and only one patient had false negative study. SPECT/CT has changed the management in one patient which was missed by planar imaging. Conclusions: Indeed, SPECT/CT has further increased the detection sensitivity and specificity, provides extra information of the anatomical location and the extent of involvement of the disease as compared to planar imaging alone.
Osteomyelitis

No abstract available.
Osteomyelitis*

Osteomyelitis in children has various clinical manifestations causing diagnostic and therapeutic difficulties. Inappropriate treatment of acute osteomyelitis may lead to chronic, serious and complicated condition. Chronic osteomyelitis continues to be a major cause of morbidity and disability in children living in developing countries. We present three cases of tibial osteomyelitis that have different presentations and sequalae. Our intention is to alert our colleagues, particularly primary physicians, regarding the variety of presentation and the important of early diagnosis and treatment to reduce the risk of morbidity following osteomyelitis.
Osteomyelitis

Pott's puffy tumor is a rare clinical entity, which has been described as a subperiosteal abscess in the frontal bone secondary to frontal osteomyelitis. Pott's puffy tumor can be associated with venous thrombosis, epidural abscess, subdural empyema, and brain abscess. In the present paper, we describe our experience of treating a 59-year old man who complained of a headache and a swelling of forehead. Because of bilateral lesion and obstruction of frontal recess, an external approach of the frontal sinus was carried out. To our knowledge, this is the first report of Pott's puffy tumor involving the bilateral frontal sinus.
Abscess ; Brain Abscess ; Empyema, Subdural ; Epidural Abscess ; Forehead ; Frontal Bone ; Frontal Sinus ; Headache ; Osteomyelitis ; Pott Puffy Tumor ; Venous Thrombosis

Pott's puffy tumor is an infrequent entity characterized by a subperiosteal abscess associated with frontal bone osteomyelitis. It has become rare due to the development of antibiotics and is usually seen as a complication of frontal sinusitis. Although Pott's puffy tumor is more commonly described in children, it should also be included in the differential diagnosis of swelling on the forehead in adults. Once the diagnosis is suspected, appropriate imaging should be performed to evaluate the possible complications. The treatment of Pott's puffy tumor combines medical and surgical approaches in order to prevent further complications. The goal of surgery is to drain the sinus and to excise the infected bone if necessary. The endoscopic endonasal approach is a safe and effective alternative to the external approach. This report describes the case of a 25-year-old man with Pott's puffy tumor resulting from frontal sinusitis.
Abscess ; Adult ; Anti-Bacterial Agents ; Child ; Diagnosis, Differential ; Endoscopy ; Forehead ; Frontal Bone ; Frontal Sinus ; Frontal Sinusitis ; Humans ; Osteomyelitis ; Pott Puffy Tumor

Pott's puffy tumor is a subperiosteal abscess of the frontal bone associated with the underlying frontal osteomyelitis. It has become a rare disease entity due to the development of antibiotics. Despite its rarity, it must be managed carefully because it is often associated with significant intracranial complications. We described a 12-year-old girl with Pott's puffy tumor accompanied with epidural abscess and subdural empyema, which was considered to be caused by the contralateral frontal sinusitis. To our knowledge, a Pott's puffy tumor caused by contralateral frontal sinusitis has not been reported in the literature. We discuss the clinical presentation and successful treatment of this unique case with brief review of the literature.
Abscess ; Anti-Bacterial Agents ; Child ; Empyema, Subdural ; Epidural Abscess ; Female ; Frontal Bone ; Frontal Sinus* ; Frontal Sinusitis* ; Humans ; Osteomyelitis ; Pott Puffy Tumor* ; Rare Diseases