Epiphyseal separations after neonatal osteomyelitis and septic arthritis

J Pediatr Orthop. 2000 Jul-Aug;20(4):544-9.

Abstract

Complete separation of an epiphysis is a rare complication of neonatal osteomyelitis and septic arthritis. We report two cases of pathologic epiphyseal separation after neonatal osteomyelitis, involving the distal and proximal femoral epiphyses with a follow-up of 2 and 7.5 years, respectively. Birth trauma, scurvy, and nonaccidental injury should be considered in the differential diagnosis of pathologic epiphyseal slip. The pitfalls in diagnosis are many, and plain radiograms of unossified epiphyses are often misleading. A high index of suspicion and the use of imaging modalities are useful in making an early diagnosis of epiphyseal slip. The optimal treatment is controversial, and the long-term prognosis is uncertain. The potential for recovery appears to be excellent, provided an early diagnosis is made and prompt treatment by anatomic reduction of the displaced epiphysis is instituted.

Publication types

  • Case Reports

MeSH terms

  • Arthritis, Infectious / complications*
  • Epiphyses, Slipped / diagnostic imaging
  • Epiphyses, Slipped / etiology*
  • Epiphyses, Slipped / therapy
  • Hip Joint / diagnostic imaging
  • Hip Joint / microbiology
  • Humans
  • Infant
  • Infant, Newborn
  • Knee Joint / diagnostic imaging
  • Knee Joint / microbiology
  • Osteomyelitis / complications*
  • Prognosis
  • Radiography