Ultrasonography Diagnosis of Purulent Arthritis and Osteomyelitis in Infants

Early detection of changes in the case of suspected purulent arthritis and osteomyelitis in infants can be difficult. Ultrasonography is the right imaging modality for making the final diagnosis early. The authors report on X-ray and ultrasonography findings of joints in 9 infants hospitalised in 19962000 with purulent arthritis and osteomyelitis (6 boys and 3 girls, average age 6.9 months). X-ray and ultrasonography was made at the same time, directly after the hospitalisation. Acuson 128 with a 7 MHz linear transducer was used for ultrasonography examination. In 5 joints and 2 long bones x-ray photographs were negative. Ultrasonography demonstrated purulent effusion in 8 joints (elbow 2x, knee 2x, hip joint 3x, shoulder 1x), subperiosteal abscess in 2 long bones (femur and tibia), in 2 long bones with osteomyelitis; ultrasonography was positive, too. Ultrasonography demonstrates cartilaginous non-ossified portions of skeleton, soft tissue swelling, intra-articular and /or extra-articular pathological findings. Ultrasonography is a fast, easily available, sensitive appropriate examination method particularly in a non-ossified skeleton. No additional imaging method of examination is necessary besides plain radiography. The treatment, including surgical treatment, is possible with no delay.