Osteomyelitis of the femur mimicking bone tumors: a review of 10 cases
Open Access
- 22 October 2013
- journal article
- review article
- Published by Springer Science and Business Media LLC in World Journal of Surgical Oncology
- Vol. 11 (1), 283
- https://doi.org/10.1186/1477-7819-11-283
Abstract
Background: The clinical symptoms and radiographic appearance of osteomyelitis can mimic those of bone tumors.Methods: We reviewed 10 patients with osteomyelitis of the femur who were initially diagnosed as having bone tumors and were subsequently transferred to our institution.Results: Nocturnal pain of moderate intensity occurred in seven patients, and all 10 patients had elevated C-reactive protein levels. The radiographic findings included the following: a permeative, moth-eaten osteolytic lesion in six patients, an osteolytic lesion with sclerotic borders in three patients, and cortical destruction with pathological fracture in one patient. Magnetic resonance imaging was performed for eight patients, and only one had a positive penumbra sign. All patients underwent a surgical biopsy to confirm the final diagnosis for histological analysis and cultures.Klebsiella pneumoniaewas detected in six patients andStaphylococcus aureus, the most common organism in osteomyelitis, was detected in three. Recurrence of infection occurred in five patients following debridement surgery; of these three had aKlebsiella pneumoniaeinfection. All patients received antibiotic treatment for an average of 20.4 weeks (range, 4 to 44) and surgical treatment an average of 1.8 times (range, 1 to 4). At the final follow-up, all patients were fully recovered with no signs of infection.Conclusions: When used in combination, clinical examinations, laboratory data, and radiographic findings can reliably distinguishing osteomyelitis from bone tumors.Keywords
This publication has 23 references indexed in Scilit:
- Haematogenous acute and subacute paediatric osteomyelitisThe Journal of Bone and Joint Surgery. British volume, 2012
- The “penumbra sign” on T1-weighted MRI for differentiating musculoskeletal infection from tumourSkeletal Radiology, 2007
- Subacute osteomyelitis of long bones: Diagnostic usefulness of the “penumbra sign” on MRIClinical Imaging, 2002
- The ‘penumbra sign’ on T1-weighted MR imaging in subacute osteomyelitis: Frequency, cause and significanceClinical Radiology, 1998
- Etiology of Osteomyelitis Complicating Sickle Cell DiseasePEDIATRICS, 1998
- Klebsiella bacteraemia: a report of 101 cases from National University Hospital, SingaporeJournal of Hospital Infection, 1994
- OsteomyelitisDrugs, 1993
- Acute Pubic Osteomyelitis in AthletesClinical Infectious Diseases, 1992
- Metastatic Disease in Long Bones A Proposed Scoring System for Diagnosing Impending Pathologic FracturesClinical Orthopaedics and Related Research, 1989
- Subacute Hematogenous Osteomyelitis in ChildrenJournal of Pediatric Orthopaedics, 1982