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Journal of Bone and Joint Surgery - British Volume, Vol 85-B, Issue 4, 559-564.
doi: 10.1302/0301-620X.85B4.13841  
Copyright © 2003 by British Editorial Society of Bone and Joint Surgery
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Primary subacute epiphyseal and metaepiphyseal osteomyelitis in children

DIAGNOSIS AND TREATMENT GUIDED BY MRI

A. Hempfing, MD, Resident1; R. Placzek, MD, Consultant Orthopaedic Surgeon1; T. Göttsche, MD, Consultant Radiologist2; and A. L. Meiss, MD, Professor, Head of Paediatric Orthopaedics1

1 Department of Orthopaedics
2 Department of Radiology, Klinik und Poliklinik für Orthopädie, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, D-20246 Hamburg, Germany.

Correspondence should be sent to Professor Dr A. L. Meiss.

We present three children with primary subacute epiphyseal and metaepiphyseal osteomyelitis. The diagnosis was delayed because of subtle radiological findings and mild general symptoms. Primary epiphyseal osteomyelitis is extremely rare. We believe that this is the first time that the MRI findings have been presented. In the first case they revealed a perforation into the knee and therefore an intra-articular epiphyseal approach was used for debridement. In the second and third cases the metaepiphyseal lesions showed considerable physical involvement and a metaphyseal approach was chosen. We believe that in this condition MRI is essential both for diagnosis and in the planning of surgical treatment.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General