The diagnosis of acute osteomyelitis of the pelvis.

OSTEOMYELITIS of the pelvis has a sparse bibliography, probably because of its relative infrequency in general orthopaedics. Froener (1889) istated that less than 10%/ of cases occured in the pelvis in a series of 545 cases of acute osteomyelitis; Butler (1940) gives an incidence of 8% in 500 cases of acute osteomyelitis seen at the London Hospital. Von Bergmann (1906) found 63 cases of osteomyelitis of the ilium in 71 cases of osteomyelitis of the pelvis. Krasnobajiv (1925), Simmons (1915), Bearse (1923), Flickinger (1927) and Buosanti (1924) each give an incidence of osteomyelitis of the ilium of between 2% and 7%. Young (1934), in his review of osteomyelitis of the ilium, to which he added three cases of his own, stated that "acute osteomyelitis of the pubis and ischium is so rare it is hardly necessary to give it consideration". His paper is the last comprehensive review of pelvic osteomyelitis, but referred only to the ilium. This paper concerns the diagnosis of acute osteomyelitis of the pelvis lin 18 patients seen in the Orthopaedic Departments of the Royal Infirmary and Childrens' Hospital in Sheffield between 1948 and 1964. Thirty case records of pelvic osteomyelitis were found among 616 cases of acute osteomyeliltis of all bones seen during this period, but only 18 were documented sufficiently well for study. This gives an incidence of 5% of osteomyelitis occurring in the pelvis. Osteitis pubis due to surgery or trauma has not been included. Although this condition is more common than acute haematogenous osteomyelitis of the pelvis it is a separate entity. The principles of treatment of pelvic osteomyelitis do not differ from those of osteomyeitis in other bones and will not be discussed.