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Journal of the Korean Society of Neonatology 1999;6(1):98-105.
Published online January 1, 2001.
Clinical Manifestations and Ultrasonographic Findings of Neonatal Septic Arthritis and Osteomyelitis.
Hyeon Jeong Cho, Byeong Il Lim, Byeong Gu Kong, Woo Ki Lee, Kwang Woo Kim, Kwi Ryun Kwon
1Department of Pediatrics, Han dong University, Sunlin Hospital, Pohang, South Korea.
2Diagnostic Radiology, Han dong University, Sunlin Hospital, Pohang, South Korea.
Abstract
PURPOSE
This study was performed to evaluate clinical manifestations and findings of ultrasonogram of neonatal septic arthritis and osteomyelitis. We tried to determine the value of ultrasonogram as a tool for early diagnosis of septic arthritis and osteomyelitis.
METHODS
We reviewed the records of 17 patients, who were diagnosed septic arthritis and/or osteomyelitis in Departments of Pediatrics and Orthopedic Surgery, Han dong University Sunlin Hospital in Pohang between Jan. 1994 and Sep. 1998. Radiologic findings were reviewed retrospectively according to the duration of symptoms at the onset. We compared the sensitivity of ultrasonogram with other radiologic tools done within 7 days of illness.
RESULTS
We compared sensitivity of each imaging study done within 7 days of illness. 20%(3/5) had abnormality in plain radiographs, 78.6%(11/14) in ultrasonogram, 28.6%(2/7) in bone scan, and 100,0%(3/3) in MRI. Deep soft-tissue swelling around the bone was the earliest sign of acute osteomyelitis in ultrasonogram. Concurrently early septic arthritis showed deep soft tissue swelling around the joint and increased synovial effusion in ultrasonogram. CONCLUSION: Ultrasonogram is not so expensive, non-invasive, not harmful to patients, and there is no need to sedate patients for examination. Comparing with other imaging studies, the sensitivity of ultrasonogram is relatively high. Ultrasonogram is a useful diagnostic tool of septic arthritis and osteomyelitis in newbom infants.
Key Words: Ultrasonograrn, Early diagnosis, Neonatal septic arthritis, Osteomyelitis


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