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  • Title: Significance of epiphyseal cartilage enhancement defects in pediatric osteomyelitis identified by MRI with surgical correlation.
    Author: Johnson DP, Hernanz-Schulman M, Martus JE, Lovejoy SA, Yu C, Kan JH.
    Journal: Pediatr Radiol; 2011 Mar; 41(3):355-61. PubMed ID: 20936273.
    Abstract:
    BACKGROUND: Epiphyseal cartilage enhancement defects (ED) may occur in the setting of epiphyseal osteomyelitis (OM), and its significance is uncertain. OBJECTIVE: The aim of this study is to evaluate the incidence and clinical impact of epiphyseal cartilage ED in pediatric epiphyseal OM. MATERIALS AND METHODS: The 13 children involved in this retrospective review were younger than 6 years of age and diagnosed with OM. They underwent contrast-enhanced MRI and surgical exploration yielding 14 study epiphyses. Seventeen age-matched children without evidence of infection who underwent contrast-enhanced MRI in the same period yielded 28 control epiphyses. Images were reviewed for focal/global ED, correlated with cartilage abscesses and compared with surgical reports. RESULTS: Study and control ED were respectively present in 10/14 (71.4%-6 global, 4 focal) and 6/28 (21.4%-0 global, 6 focal), P=0.0017. An analysis of ED patterns between study and control patients showed significant difference for global (P=0.0006), but no difference for focal ED (P=0.71). For the six study epiphyses with global ED, epiphyseal abscesses were present in two (33.3%). For the four study epiphyses with focal ED, epiphyseal abscesses were present in two (50%). For the controls, no abnormalities were found on follow-up of epiphyses with focal ED. CONCLUSION: ED are seen normally but more commonly in children with OM. ED should not be confused with epiphyseal abscesses.
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