Journal of pediatric orthopedics
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Ultrasonography was undertaken in nine children with late presenting acute osteomyelitis, in four children with typical superficial cellulitis, and in four with a soft tissue abscess. Ultrasound distinguished between superficial cellulitis, soft tissue abscess, and subperiosteal abscess. ⋯ Ultrasonography was particularly useful in confirming the existence of a subperiosteal abscess and in localizing it precisely in children with diffuse swelling and tenderness of a limb owing to late-acute osteomyelitis. Surgical drainage of pus can be avoided in patients without ultrasound features of an abscess and can be better planned in those who require it.
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Bacterial infections of muscle, also known as pyomyositis or tropical pyomyositis, occur more commonly in tropical regions. This article reviews five cases of pyomyositis diagnosed in children over a 1-year period. Pyomyositis should be considered in the differential diagnosis of septic-appearing children as well as children complaining of joint pain or muscle aches. ⋯ The MRI is preferable because multiple processes can be evaluated, such as joint effusion suggesting septic arthritis. If the patient does not respond quickly to antibiotics and surgical intervention, either there is a recurrence of the previously debrided abscess, or there is an unrecognized secondary abscess. Multiple abscess sites should be entertained prior to initial debridement.
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We conducted a retrospective review of 155 spinal operations at our institution to determine the efficacy of intraoperative salvage. Addition of intraoperative salvage had little effect on the success of a preoperative autologous donation program. ⋯ The technique tended to be most effective in children aged 16-18 years. Use of intraoperative salvage for all pediatric spinal procedures is neither necessary nor cost effective.