Late sequelae of osteoarticular infections in pediatric patients

摘要

Osteoarticular infections (OAIs)areinfections ofthe bone(osteomyelitis)and joint (septicarthritis). They arefrequent in pediatric patients, with an incidencerate of 2 to 13 per 100,000 children annually in developed countries for osteomyelitides,and half ofthat incidenceratefor septic arthritides. [1] Nonetheless, recent literaturefocusing on thelatesequelae ofOAI has been sparse. [2] In septicarthritis ofthe hip, forexample, delayed diagnosis may lead to chondrolysis, [3] premature orasymmetricalclosing ofthetriradiatecartilage,acetabular dysplasia,and premature or asymmetricalclosure ofthe proximalfemoral physis; potentially leading to abnormalangulation and limb-length discrepancy (LLD). [4,5] Damageto theepiphyseal vascular supplymay result in avascular necrosis ofthefemoral head and metaphysis,causing joint destruction, hip instability,and even dislocation and pseudoarthrosis ofthefemoral neck. [4,6,7] Similar sequelae werealso reported in other joints. Forexample, septicarthritis of theshouldercan cause humeralshortening and subluxation; [8] in long bones, osteomyelitiscan result in epiphysiodesisand LLDas wellasangular limb deformity.