Hematogenous epiphyseal osteomyelitis in children: three case reports

Background: The epiphysis is a rather uncommon location of hematogenous osteomyelitis involvement. Because the transphyseal arteries vanish about 15-18 months of age, epiphyseal osteomyelitis was previously assumed to occur mainly in newborns under one year of age.Methods and Results In this case report, we present three cases of epiphyseal osteomyelitis who are older than 18 months. Most doctors believe that epiphyseal osteomyelitis caused by bacteria often has a good prognosis and cures without long-term complications. In our study, one patient underwent timely aggressive surgical treatment combined with antibiotic therapy in the early course of the disease. Seven months after surgery, his laboratory examinations were normal with no evidence of recurrence. But he had limited flexion and extension of the knee, and the range of motion was 20°- 100°. This complication was not reported in any of the previous studies. ConclusionsThe diagnosis of epiphyseal osteomyelitis is often delayed because of silent symptoms, mild radiological changes, and atypical location. Physicians should be aware of the clinical and radiographic features of this disease so that it can be diagnosed and treated as soon as possible to prevent further development and complications.