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A systematic review of pelvic infective osteomyelitis in children: current state of evidence

Vishal Kumar, S. Barik, V. Garg, V. Raj, S. Arora

Journal of Tropical Pediatrics, 2024

277 participants · 4 citations

Abstract

Musculoskeletal infection of pelvis can be confused with septic arthritis of the hip, irritable hip, sacroiliitis, and spondylodiscitis in the initial period. This study aimed to present the complete clinical picture of pelvic infective osteomyelitis (PIO) in children along with its natural course. Two researchers independently used PubMed and Scopus electronic databases for the literature review. This review includes all studies reporting PIO in the pediatric age group. The final inclusion of 11 eligible studies was done. A total of 277 patients were analyzed from the included studies with the majority of males (158/242, 65.2%). Hip and groin pain (147/195, 75.3%) and limp (155/249, 62.2%) were the common presenting symptoms. Increased systemic temperature (83/103, 80.5%) and localized tenderness at the hip joint area (90/121, 74.3%) were among the commonest signs. Magnetic resonance imaging was an investigation of choice for diagnosis (89/93, 95.6%). Blood culture showed growth in 47.6% (119/250) patients with Staphylococcus aureus (83/102, 81.3%) being the most common isolated organism. Treatment with sensitive antibiotics was the mainstay of management with surgery for debridement or biopsy being required in only 16.1% (23/142) of the patients. PIO in children is a rare condition mimicking several other disease processes affecting the neighboring tissues the diagnosis of which gets limited in low-resource settings. Further prospective clinical studies are the need of the…

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Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 277 participants or records.

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