A systematic review of pelvic infective osteomyelitis in children: current state of evidence.

IF 1.8 4区 医学 Q2 PEDIATRICS Journal of Tropical Pediatrics Pub Date : 2024-10-04 DOI:10.1093/tropej/fmae043
Vishal Kumar, Sitanshu Barik, Varun Garg, Vikash Raj, Shobha S Arora
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Abstract

Musculoskeletal infection of pelvis can be confused with septic arthritis of the hip, irritable hip, sacroiliitis, and spondylodiscitis in the initial period. This study aimed to present the complete clinical picture of pelvic infective osteomyelitis (PIO) in children along with its natural course. Two researchers independently used PubMed and Scopus electronic databases for the literature review. This review includes all studies reporting PIO in the pediatric age group. The final inclusion of 11 eligible studies was done. A total of 277 patients were analyzed from the included studies with the majority of males (158/242, 65.2%). Hip and groin pain (147/195, 75.3%) and limp (155/249, 62.2%) were the common presenting symptoms. Increased systemic temperature (83/103, 80.5%) and localized tenderness at the hip joint area (90/121, 74.3%) were among the commonest signs. Magnetic resonance imaging was an investigation of choice for diagnosis (89/93, 95.6%). Blood culture showed growth in 47.6% (119/250) patients with Staphylococcus aureus (83/102, 81.3%) being the most common isolated organism. Treatment with sensitive antibiotics was the mainstay of management with surgery for debridement or biopsy being required in only 16.1% (23/142) of the patients. PIO in children is a rare condition mimicking several other disease processes affecting the neighboring tissues the diagnosis of which gets limited in low-resource settings. Further prospective clinical studies are the need of the hour to validate the guideline proposed. Explorative studies to define a clinical scoring system to differentiate septic arthritis of the hip from PIO may be considered.

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儿童骨盆感染性骨髓炎系统综述:证据现状。
骨盆的肌肉骨骼感染在初期可与髋关节化脓性关节炎、髋关节炎、骶髂关节炎和脊柱盘炎混淆。本研究旨在介绍儿童骨盆感染性骨髓炎(PIO)的完整临床表现及其自然病程。两位研究人员独立使用 PubMed 和 Scopus 电子数据库进行了文献综述。本综述包括所有报道儿科年龄组 PIO 的研究。最终纳入了 11 项符合条件的研究。在纳入的研究中,共分析了 277 名患者,其中男性居多(158/242,65.2%)。臀部和腹股沟疼痛(147/195,75.3%)和跛行(155/249,62.2%)是常见的症状。全身体温升高(83/103,80.5%)和髋关节局部触痛(90/121,74.3%)是最常见的体征。磁共振成像是诊断的首选检查(89/93,95.6%)。血液培养显示,47.6%(119/250)的患者体内有金黄色葡萄球菌生长(83/102,81.3%),金黄色葡萄球菌是最常见的分离菌。使用敏感抗生素治疗是主要的治疗方法,只有 16.1%(23/142)的患者需要手术清创或活检。儿童脓疱疮是一种罕见的疾病,它模仿影响邻近组织的其他几种疾病过程,在资源匮乏的环境中诊断十分有限。目前需要进一步开展前瞻性临床研究,以验证所提出的指南。可以考虑进行探索性研究,以确定临床评分系统,将髋关节化脓性关节炎与髋关节周围炎区分开来。
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来源期刊
Journal of Tropical Pediatrics
Journal of Tropical Pediatrics 医学-热带医学
CiteScore
4.00
自引率
0.00%
发文量
97
审稿时长
6-12 weeks
期刊介绍: The Journal of Tropical Pediatrics provides a link between theory and practice in the field. Papers report key results of clinical and community research, and considerations of programme development. More general descriptive pieces are included when they have application to work preceeding elsewhere. The journal also presents review articles, book reviews and, occasionally, short monographs and selections of important papers delivered at relevant conferences.
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