Grattan-Smith J D, Wagner M L, Barnes D A
Department of Radiology, Texas Children's Hospital, Houston.
AJR Am J Roentgenol. 1991 Apr;156(4):785-9. doi: 10.2214/ajr.156.4.2003447.
Hematogenous osteomyelitis of the talus is a rare and infrequently considered cause of limping in children. We describe five children younger than 2 years of age with osteomyelitis of the talus who had a limp and a paucity of constitutional symptoms. Conventional radiography and scintigraphy were the imaging techniques used. The usual radiologic features include soft-tissue swelling and an osteolytic defect in the talus without sequestrum formation of periosteal reaction. Bone scans were positive in all cases and led to the localization of the lesion in two patients. Definitive diagnosis was made in all cases only after needle aspiration or open biopsy and curettage. Increased awareness of this unusual lesion and its subtle early radiologic manifestations will allow prompt diagnosis and treatment.
距骨血源性骨髓炎是儿童跛行的一种罕见且较少被考虑到的病因。我们描述了5名2岁以下患有距骨骨髓炎的儿童，他们均有跛行且全身症状较少。使用的影像学技术为传统X线摄影和骨闪烁显像。常见的放射学特征包括软组织肿胀以及距骨的溶骨性缺损，无死骨形成或骨膜反应。所有病例的骨扫描均为阳性，其中2例据此明确了病变部位。所有病例均仅在经皮穿刺抽吸或切开活检及刮除术后才得以确诊。提高对这种不常见病变及其早期细微放射学表现的认识，将有助于实现早期诊断和治疗。
