Clinical characteristics of acute epiphyseal osteomyelitis and acute metaphyseal osteomyelitis of long bones in children

This study aimed to summarize the clinical characteristics of acute epiphyseal osteomyelitis and acute metaphyseal osteomyelitis of long bones in children. Data of 43 children with acute osteomyelitis of long bones diagnosed and treated from November 2017 to January 2021 were retrospectively analyzed. Medical records, laboratory results, and MRI were reviewed. Surgical drainage of lesions was done to retrieve infective fluid and tissue for examination. There were 12 cases of metaphyseal and epiphysis involvement, including five boys and seven girls, aged from 1 to 12 years old, and the length of hospitalization was 21-45 days. There were six cases of distal femur, five cases of proximal tibia, and one case of distal humerus. The pathogenic microorganisms were methicillin-sensitive Staphylococcus aureus (MSSA) in six cases and methicillin-resistant Staphylococcus aureus (MRSA) in six cases. No complications were reported during the follow-up. Thirty-one cases of simple metaphyseal involvement, including 20 boys and 11 girls, aged 19 days to 12 years, and the length of hospitalization was 18-60 days. Twelve cases of distal femur, 11 cases of proximal tibia, three cases of distal humerus, two cases of proximal tibiofibular, two cases of proximal fibula, and one case of proximal ulna. The pathogenic microorganism was MSSA in 26 cases and MRSA in five cases. One patient with knee contracture during follow-up. Epiphyseal osteomyelitis is rare but can occur in older children. The prognosis is good with aggressive surgical treatment.