Osteomyelitis in children with sickle cell disease: early diagnosis with contrast-enhanced CT.

Two children with sickle cell disease and osteomyelitis were treated. In one child, definitive treatment was delayed until computed tomography (CT) revealed a subperiosteal abscess. Early performance of CT in the other child resulted in prompt diagnosis and treatment. Before the appearance of the characteristic plain radiographic findings, diagnosis of osteomyelitis in patients with sickle cell disease can be difficult because the clinical manifestations of infarction and osteomyelitis can be similar. Radionuclide scans have yielded mixed results. In equivocal cases, early performance of CT can help establish the diagnosis of osteomyelitis to avoid significant morbidity.