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Pediatric Patients with Osteomyelitis and/or Septic Joint Undergoing Surgical Debridement Have Equivalent Short-Term Outcomes with or without Preoperative MRI.
Englert, E Graham; Braithwaite, Collin L; Aguirre-Flores, Maria E; Lam, Aaron W; Sarraj, Mohamed; Kumagai, Abigail; Bednar, E Dimitra; Gordon, Adam M; Salama, Ibrahim; Keeley, Jacob; Pathak, Indu; Kishta, Waleed; Thabet, Ahmed M; Abdelgawad, Amr; Saleh, Ehab.
Afiliación
  • Englert EG; Department of Orthopaedic Surgery, Beaumont Hospital Royal Oak, Royal Oak, MI 48073, USA.
  • Braithwaite CL; Department of Orthopedic Surgery, Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA.
  • Aguirre-Flores ME; Department of Pediatrics, Texas Tech University Health Sciences Center, El Paso, TX 79905, USA.
  • Lam AW; Department of Orthopedic Surgery, Maimonides Medical Center, Brooklyn, NY 11219, USA.
  • Sarraj M; Division of Orthopaedic Surgery, McMaster University, Hamilton, ON L8S 4L8, Canada.
  • Kumagai A; Department of Ophthalmology and Visual Sciences, The Ohio State University College of Medicine, Columbus, OH 43210, USA.
  • Bednar ED; Department of Medicine, University of Toronto, Toronto, ON M1C 1A4, Canada.
  • Gordon AM; Department of Orthopedic Surgery, Maimonides Medical Center, Brooklyn, NY 11219, USA.
  • Salama I; Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA.
  • Keeley J; Department of Orthopedic Surgery, Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA.
  • Pathak I; Department of Pediatrics, Texas Tech University Health Sciences Center, El Paso, TX 79905, USA.
  • Kishta W; Division of Orthopaedic Surgery, McMaster University, Hamilton, ON L8S 4L8, Canada.
  • Thabet AM; Department of Orthopaedic Surgery, Texas Tech University Health Sciences Center, El Paso, TX 79905, USA.
  • Abdelgawad A; Department of Orthopedic Surgery, Maimonides Medical Center, Brooklyn, NY 11219, USA.
  • Saleh E; Department of Orthopaedic Surgery, Beaumont Hospital Royal Oak, Royal Oak, MI 48073, USA.
Children (Basel) ; 11(3)2024 Mar 02.
Article en En | MEDLINE | ID: mdl-38539335
ABSTRACT
The purpose of this study was to determine if short-term outcomes differed for pediatric patients with suspected musculoskeletal infection with or without a preoperative MRI. This was a multicenter, retrospective review of patients aged 0-16 years who presented with atraumatic extremity pain, underwent irrigation and debridement (I&D), and received at least one preoperative or postoperative MRI over a 10-year period. Primary outcomes were time to OR, total I&Ds, readmission rate, time from OR to discharge, and total number of MRIs. Secondary outcomes entailed the rate at which concurrent osteomyelitis was identified in patients with septic arthritis and the extent of the resulting surgical debridement. Of the 104 patients, 72.1% had a preoperative MRI. Patients with a preoperative MRI were significantly less likely to have surgery on the day of admission. No difference was found between groups regarding total I&Ds, readmission rate, time from OR to discharge, and total number of MRIs. Of the 57 patients diagnosed with septic arthritis, those with a preoperative MRI were significantly more likely to have concurrent osteomyelitis identified and to undergo bony debridement in addition to arthrotomy of the joint. In conclusion, patient outcomes are not adversely affected by obtaining a preoperative MRI despite the delay in time to OR. Although preoperative MRI can be beneficial in ruling out other pathologies and identifying the extent of concurrent osteomyelitis, the decision to obtain a preoperative MRI and timing of surgery should be left to the discretion of the treating surgeon.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Children (Basel) Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Children (Basel) Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza