Massive Humeral Osteolysis: A Rare Complication of Osteomyelitis

Auteurs

  • Ana Luísa Lourenço Radiology department. Hospital Dona Estefânia, Centro Hospitalar e Universitário de Lisboa Central, Lisboa, Portugal
  • Lúcia Nascimento Radiology department. Hospital Dona Estefânia, Centro Hospitalar e Universitário de Lisboa Central, Lisboa, Portugal
  • Pedro Alves Radiology department. Hospital Dona Estefânia, Centro Hospitalar e Universitário de Lisboa Central, Lisboa, Portugal
  • Maria José Costa Physical Medicine and Rehabilitation department. Hospital Dona Estefânia, Centro Hospitalar e Universitário de Lisboa Central, Lisboa, Portugal

DOI :

https://doi.org/10.25759/spmfr.388

Mots-clés :

Humerus, Osteolysis/diagnostic imaging, Osteomyelitis/complications

Résumé

Introduction: Osteomyelitis may lead to severe complications, such as bone necrosis, which can result in segmental bone defects. Nowadays, this is a very rare complication due to the proper antibiotic therapy and surgical management.

Case Report: We describe the case of a six-year-old child referred to our institution with a massive humeral osteolysis due to a complication from a right arm pan-osteomyelitis, without previous surgical intervention. Physical examination revealed a deformable arm due to bone support absence. However, some movements of elbow flexion/extension and shoulder elevation were still preserved.

Discussion: This paper describes a very rare case of an extensive bone segmental osteolysis due to osteomyelitis, which is interesting not only for its rarity and peculiar imaging and clinical presentation, but also for the fact that the child preserves some arm movements, using compensation/ recruitment mechanisms.

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Biographie de l'auteur

Ana Luísa Lourenço, Radiology department. Hospital Dona Estefânia, Centro Hospitalar e Universitário de Lisboa Central, Lisboa, Portugal

Interna de Formação específica de Radiologia no Centro Hospitalar e Universitário de Lisboa Central.

Références

Castellazzi L, Mantero M, Esposito S. Update on the Management of Pediatric Acute Osteomyelitis and Septic Arthritis. Int J Mol Sci. 2016; 17: 855-63. doi:10.3390/ijms17060855

Arnold JC, Bradley JS. Osteoarticular infections in children. Infect Dis Clin N Am. 2015; 29: 557–74. doi: 10.1016/j.idc.2015.05.012

Principi N, Esposito S. Infectious discitis and spondylodiscitis in 4. Conrad DA. Acute hematogenous osteomyelitis. Ped Rev. 2010; 31:464-71. doi: 10.1542/pir.31-11-464

Shukrimi A, Ariff MS, Zamzuri Z, Mai Ashikin NT. Chronic Tibial Osteomyelitis in Children. A Case Review at Hospital Tengku Ampuan Afzan, Kuantan. Med J Malaysia. 2015; 70: 48-51.

Agarwal A, Aggarwal AN. Bone and joint infections in children: Acute hematogenous osteomyelitis. Indian J Pediatr. 2015; 83:1–8. doi: 10.1007/s12098-015-1806-3

Pääkkönen M, Peltola H. Management of a child with suspected acute septic arthritis. Arch Dis Child. 2012; 97: 287–92. doi: 10.1136/archdischild-2011-300462

Jones H, Beckles V, Akinola B, Stevenson A, Harrison W. Chronic haematogenous osteomyelitis in children. An unsolved problem. J Bone Joint Surg. 2011;93-B:1005-10. doi:10.1302/0301-620X.93B8.25951

Desimpel J, Posadzy M, Vanhoenacker FM. The many faces of osteomyelitis: a pictorial review. J Belg Soc Radiol . 2017;101:24. doi: 10.5334/jbr-btr.1300.

Pineda C, Espinosa R, Pena A. Radiographic imaging in osteomyelitis: the role of plain radiography, computed tomography, ultrasonography, magnetic resonance imaging, and scintigraphy. Semin Plast Surg. 2009;23:80-9. doi: 10.1055/s-0029-1214160.

Pincher B, Fenton C, Jeyapalan R, Barlow G, Sharma HK. A systematic review of the single-stage treatment of chronic osteomyelitis. J Orthop Surg Res. 2019;14:393. doi: 10.1186/s13018-019-1388-2.

Spiegel DA, Penny JN. Chronic Osteomyelitis in Children. Tech Orthop. 2005; 20:142–152. doi: 10.1097/01.bto.0000162988.21990.f6

Wirbel R, Hermans K. Surgical treatment of chronic osteomyelitis in children admitted from developing countries. Afr J Paediatr Surg. 2014;11:297-303. doi: 10.4103/0189-6725.143133.

Muscolino JE, editor. Kinesiology: the skeletal system and muscle function. 3rd ed. Amsterdam: Elsevier; 2017.

Weissman SL, Salama R. Spontaneous osteolysis following acute osteomyelitis. JAMA. 1962: 182: 1122-3. doi:10.1001/jama.1962.03050500054015b

Lasanianos N, Kanakaris N, Giannoudis P. Current management of long bone large segmental defects. Orthop Trauma J. 2009; 24: 149-63. doi:10.1016/j.mporth.2009.10.003

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Publiée

2021-01-14

Comment citer

1.
Lourenço AL, Nascimento L, Alves P, Costa MJ. Massive Humeral Osteolysis: A Rare Complication of Osteomyelitis. SPMFR [Internet]. 14 janv. 2021 [cité 30 oct. 2024];32(4):179-84. Disponible sur: https://spmfrjournal.org/index.php/spmfr/article/view/388

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Caso Clínico