Verbeek Paul A, de Roest Jorien G, van Raaij Tom M
Martini Ziekenhuis, Afd. Orthopedie, Groningen, the Netherlands.
Ned Tijdschr Geneeskd. 2012;155(35):A5103.
Haematogenous osteomyelitis of the talus is a rare cause of limping in children. Due to the slow onset and atypical pattern of symptoms, it is difficult to diagnose. This can result in delays in the provision of adequate treatment.
A 3-year old girl was examined in the outpatient ward for pain in the right leg and limping. A diagnosis of coxitis fugax was suspected initially. Supplemental laboratory testing, conventional roentgenograms and bone scintigraphy however, showed a haematogenous osteomyelitis of the talus. The patient was treated with flucloxacillin. She was symptom-free four months after the first outpatient visit, with full recovery of function in her right ankle and foot.
Haematogenous osteomyelitis of the talus is rare in children. The diagnosis is often missed because symptoms are often subtle in the early phase. It is important to choose imaging techniques carefully because treatment with antibiotics is sufficient when this type of osteomyelitis is detected at an early stage.
距骨血源性骨髓炎是儿童跛行的罕见原因。由于其起病缓慢且症状不典型，难以诊断。这可能导致在提供充分治疗方面出现延误。
一名3岁女孩因右腿疼痛和跛行在门诊接受检查。最初怀疑为短暂性髋关节炎。然而，补充实验室检查、传统X线片和骨闪烁显像显示为距骨血源性骨髓炎。患者接受氟氯西林治疗。首次门诊就诊四个月后症状消失，右踝和足部功能完全恢复。
距骨血源性骨髓炎在儿童中罕见。由于早期症状往往不明显，诊断常常被漏诊。仔细选择影像学检查技术很重要，因为早期发现这种类型的骨髓炎时，抗生素治疗就足够了。
