Document Detail


Ultrasonography: can it differentiate between vasoocclusive crisis and acute osteomyelitis in sickle cell disease?
MedLine Citation:
PMID:  9661872     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We prospectively evaluated the results of ultrasonography in 53 patients of sickle cell disease suspected to have vasoocclusive crisis/acute hematogenous osteomyelitis. The average age was 8.4 +/- 3.40 years (range, 1-14). Twenty-six children were boys and 27 were girls. Seventeen (32%) patients had ultrasonographic changes that suggested acute osteomyelitis. The minimal white cell count was 7,200/mm3, and maximal, 9,900/mm3 (mean, 8,190/mm3) in uninfected patients and in 17 patients, the mean was 10,300/mm3 (7,200-13,600/mm3). The mean erythrocyte sedimentation rate in uninfected patients was 32 for the first hour (19-36 mm), and in infected patients, it was 43 for the first hour (35-38 mm). Pus culture was positive in all infected patients, and the infective organism was Salmonella enteriditis in eight, staphylococcal species in six (S. aureus in four and S. epidermidis in two), and Streptococcus species 1 and 2, anaerobic streptococci. All patients with vasoocclusive crisis were treated with analgesics and intravenous fluids and did not require any further treatment. In patients with acute osteomyelitis, the treatment was incision, drainage and drilling of bone, and antibiotic therapy. We conclude that ultrasonography clearly and decisively differentiated acute osteomyelitis from vasoocclusive crisis in patients with sickle cell disease.
Authors:
M Sadat-Ali; K al-Umran; I al-Habdan; F al-Mulhim
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of pediatric orthopedics     Volume:  18     ISSN:  0271-6798     ISO Abbreviation:  J Pediatr Orthop     Publication Date:    1998 Jul-Aug
Date Detail:
Created Date:  1998-10-13     Completed Date:  1998-10-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8109053     Medline TA:  J Pediatr Orthop     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  552-4     Citation Subset:  IM    
Affiliation:
King Fahd Hospital of the University, Al-Khobar, Saudi Arabia.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Anemia, Sickle Cell / complications*
Arterial Occlusive Diseases / diagnosis,  etiology,  ultrasonography
Child
Child, Preschool
Diagnosis, Differential
Emergencies
Female
Humans
Male
Osteomyelitis / diagnosis,  etiology,  ultrasonography*
Prospective Studies
Sensitivity and Specificity
Staphylococcal Infections / diagnosis,  etiology,  ultrasonography*
Vascular Diseases / diagnosis,  etiology,  ultrasonography*

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