The Journal of Bone and Joint Surgery, Vol 63, Issue 1 107-114, Copyright © 1981 by Journal of Bone and Joint Surgery, Inc
Primary subacute epiphyseal osteomyelitis
NE Green, RD Beauchamp and PP Griffin
In eight children with primary subacute osteomyelitis of a femoral or
tibial epiphysis, the only complaints were pain and limp. Plain
roentgenograms and tomograms showed a well defined lytic lesion in the
epiphysis and no evidence of any connection to the metaphysis. Although the
bone of the epiphysis was involved in every instance, and the lesion
extended to the articular cartilage in most patients, the cartilage itself
was not damaged. When the lesions were curetted, six were sterile on
routine and anaerobic cultures and on culture for tuberculous and fungal
organisms, and Staphylococcus was grown from the other two. In every case
the curetted tissue had the characteristic histological appearence of
osteomyelitis. All patients were treated with oxacillin and recovered
completely. Postoperative roentgenograms showed complete healing with no
evidence of damage to the physis or the joint after follow-up of two to
eight years.
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