How To Detect Pediatric Osteomyelitis

By Michael Schreck, DPM

   Although both acute hematogenous osteomyelitis (AHO) and chronic recurrent multifocal osteomyelitis (CRMO) are somewhat uncommon, differentiating between the two can be tricky. Having a strong grasp of the etiology and presentation of these conditions can go a long way toward preventing a delayed or inappropriate diagnosis, which could be harmful for pediatric patients.    Pediatric hematogenous osteomyelitis may occur secondary to a traumatic injury and/or an acquired illness or other immunosuppressive condition. Acute hematogenous osteomyelitis reportedly affects one in 5,000 children in the United States under the age of 13 with half of all cases occurring in children under 5.1-3 The condition can be quite dangerous in prognosis if the diagnosis is delayed. Therefore, it is essential to be able to differentiate between AHO and other conditions.    Chronic recurrent multifocal osteomyelitis is a separate and rare disorder that affects children and teenagers. The condition is an inflammatory disorder of unknown etiology that involves different osseous sites and has some association with psoriasis and palmoplantar pustulosis. While antibiotic therapy usually works for AHO, one would primarily treat CRMO with antiinflammatories.    That said, let us take a closer look at each condition.

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