Journal of Ultrasound in Medicine, Vol 18, Issue 11 729-734, Copyright © 1999 by American Institute of Ultrasound in Medicine
Color Doppler ultrasonographic evaluation of osteomyelitis in children
H. C. Chao, S. J. Lin, Y. C. Huang and T. Y. Lin
Department of Pediatrics, Chang Gung Children's Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
We investigated the capability of color Doppler sonography in evaluating
acute osteomyelitis in children. Twelve children suspected of having
osteomyelitis were evaluated with color Doppler ultrasonography at
admission and at regular intervals to observe the inflammatory process of
osteomyelitis, determine the response of antibiotic therapy, and predict
the need of surgery in these patients. At admission, color Doppler flow
within or around the infected periosteum was found in patients with
symptoms for 4 days or longer, whereas those with symptoms for less than 4
days showed no color Doppler flow within and around the periosteum. During
sonographic follow-up, six cases were found to have increased color Doppler
vascular flow within and around the affected periosteum, and two of them
had periosteal abscess. They eventually required surgical treatment.
Persistent or increased color Doppler flow during follow-up examination
correlated with elevated serum levels of C-reactive protein as well. Our
study indicated that color Doppler vascular flow within or around the
infected periosteum correlated with advanced acute osteomyelitis, and
surgery usually was required in these patients. Those with early stage
acute osteomyelitis usually showed no vascular flow within or around the
infected periosteum. Thus, color Doppler sonography allowed detection of
advanced osteomyelitis and revealed the progression of inflammation during
antibiotic therapy. Color Doppler ultrasonography might be valuable in
determining the efficacy of antibiotic therapy and justifying the need for
operation.
