Fonseca Madalena, Lobão Correia Beatriz, Girbal Inês, Lobo Luísa, Abrantes Margarida, Berenguer Alberto
Serviço de Pediatria, Departamento de Pediatria, Hospital de Santa Maria, ULSSM, Lisbon, Portugal.
Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal.
Ultrasound. 2025 Jul 11:1742271X251353711. doi: 10.1177/1742271X251353711.
Neonatal osteomyelitis is rare, and rib involvement is even more uncommon. Early diagnosis is challenging due to nonspecific clinical signs and the limitations of conventional imaging methods.
To describe a case of neonatal rib osteomyelitis and highlight the diagnostic utility of point-of-care ultrasound in its early detection.
A case of a 25-week preterm neonate with a localized thoracic swelling was investigated. Diagnosis was made using point-of-care ultrasound, which identified a fluid collection and cortical disruption, while radiography showed no abnormalities. A review of the literature was conducted to compare findings with other reported cases.
The neonate was diagnosed with rib osteomyelitis caused by Staphylococcus aureus and treated with a 6-week course of targeted antibiotics. The infant made a full recovery. A literature review revealed three other cases of neonatal rib osteomyelitis, all associated with S. aureus, with localized swelling as the primary clinical symptom. Imaging results varied, with ultrasound proving to be more sensitive than radiography in early detection. None of the cases underwent magnetic resonance imaging.
Neonatal rib osteomyelitis, though extremely rare, should be considered in neonates presenting with localized chest wall abnormalities. Point-of-care ultrasound is a valuable diagnostic tool, enabling early detection and potentially improving outcomes through timely intervention.
新生儿骨髓炎较为罕见，肋骨受累更为少见。由于临床症状不具特异性以及传统影像学方法存在局限性，早期诊断颇具挑战性。
描述1例新生儿肋骨骨髓炎病例，并强调床旁超声在其早期检测中的诊断价值。
对1例25周早产新生儿出现局限性胸部肿胀的病例进行调查。通过床旁超声进行诊断，超声发现有液体积聚和皮质破坏，而X线摄影未显示异常。对文献进行回顾，以将本病例的发现与其他报告病例进行比较。
该新生儿被诊断为金黄色葡萄球菌引起的肋骨骨髓炎，并接受了为期6周的针对性抗生素治疗。患儿完全康复。文献回顾显示另有3例新生儿肋骨骨髓炎病例，均与金黄色葡萄球菌有关，主要临床症状为局限性肿胀。影像学结果各异，超声在早期检测中被证明比X线摄影更敏感。所有病例均未进行磁共振成像检查。
新生儿肋骨骨髓炎虽然极为罕见，但对于出现局限性胸壁异常的新生儿应予以考虑。床旁超声是一种有价值的诊断工具，能够实现早期检测，并有可能通过及时干预改善预后。
