Possibilities of differentiation of various processes that cause focal destruction of small and flat bones in children

Abstract

Purpose of the study. Systematize Rg, CT and MRI semiotics of destructive processes in flat and spongy bones in children and determine the diagnostic significance of various X-ray signs for differentiating tuberculosis and other destructive processes and the statistical relationship between them.

Material and methods. 123 children with suspected tuberculous osteitis were selected for the study. Tuberculous osteomyelitis was detected in 80 (65.1%) patients, nonspecific osteomyelitis in 27 (21.9%), non-bacterial osteomyelitis and oncological processes in 8 (6.5%), respectively.

Results. Fistulous process is more common in tuberculous osteomyelitis. Temperature rise to febrile numbers — in patients with nonspecific osteomyelitis. Their combination was found only with tuberculosis. Tuberculosis was characterized by large (>10 mm), single cavities with a clear contour, with the presence of sequesters. Nonspecific osteomyelitis was characterized by smaller (5–10 mm), single cavities without destroying the cortical closing plate. In case of non-bacterial osteomyelitis, multiple cavities with a clear contour, with the presence of sequesters, were more oftenly detected. Oncological processes were characterized by swelling of the bone with the presence of periostitis, as well as large single cavities with a clear contour, with sclerotic changes in the surrounding bone tissue. In some cases, a solid component in soft tissues was visualized. Conclusion. The radiological and cli nical picture is often non-specific for the pathology in question, however, the identification of some symptoms makes it possible to suspect a certain pathological process with a certain degree of probability, which ultimately should lead to a shortening of the diagnostic pause.