L. Chater et al. / Open Journal of Pediatrics 3 (2013) 291-293
Copyright © 2013 SciRes.
293
Ultrasound can explore early and quite different facets of
the pelvic bone in search of a subperiosteal abscess.
Bone scintigraphy can also provide early signs showing a
hypersignal in pubic symphysis [4].
OPEN ACCESS
MRI appears the most effective for the diagnosis of
osteomyelitis of the pubis [8]. It shows signs of edema
and inflammation resulting in abnormal signal of the
bone and the symphysis, or muscles. This is a crucial
consideration in assessing the presence and extent of
pubic infection. The typical appearance is localized with
decreased signal on T1-weighted images and signal en-
hancement in T2-weighted image area.
Staphylococcus aureus is the organism most com-
monly involved. Its isolation is made by blood cultures
and puncture-aspiration, if not by open surgery [3,8,10].
The main differential diagnosis is with osteitis pubis in
athletes. Originally described by Beer in 1924, osteitis
pubis is an inflammatory process and non-infectious
[8,9,11-13]. The sports activity is a predisposing factor
[4,6-9,12,14]. It usually occurs after surgery of the uro-
genital tract. Osteitis of the athlete could increase the risk
of osteomyelitis [12].
The treatment of pubic osteomyelitis requires appro-
priate antibiotic. Initially antibiotics are given intrave-
nously for two weeks, followed by oral antibiotics for at
least six weeks. In rare cases, surgery is necessary to
drain a retropubic abscess, curettage of the lesion or re-
moval of bone sequestration [3,10].
4. CONCLUSIONS
A good knowledge of the disease should allow a diagno-
sis before the stage of subperiosteal abscesses and early
treatment, which makes the exceptional surgical indica-
tions.
These conditions are often overlooked or masked by
abdominal pain, which may lead to unnecessary tests and
procedures.
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