Optimal Timing for Advanced Imaging in Childhood Bone and Joint Infection.

IF 1.4 3区 医学 Q3 ORTHOPEDICS
Sarah Hunter, Elsie Brown, Haemish Crawford, Cameron Grant
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引用次数: 0

Abstract

Objective: Advanced imaging in the management of childhood bone and joint infection (BJI) has the potential to improve disease outcomes. Knowledge about the optimal timing for magnetic resonance imaging (MRI) in relation to both surgically and nonsurgically managed BJI is limited. This study examines the impact of MRI timing on number of surgeries, length of stay (LOS), hospitalization cost, and disease recurrence in childhood BJI.

Methods: This is a retrospective review of patients younger than 16 years with acute hematogenous osteomyelitis (AHO) or septic arthritis (SA) treated in the Auckland region from 2018 to 2023. Cases undergoing MRI as part of diagnostic workup were included. Treatment, hours between admission and MRI, LOS, hospitalization cost, and infection recurrence were assessed.

Results: There were 563 cases of BJI, of which 390 met the inclusion criteria. Cases were primarily AHO (85%). The percentage of cases having MRI increased over time from 54% (2018) to 80% (2023). Locally disseminated infections such as subperiosteal abscess or adjacent septic arthritis occurred in 48%. Children with preoperative (n = 145) versus postoperative MRI (n = 60) had a lower reoperation rate (33% vs 77%, P = 0.001) and shorter LOS (14.1 vs 22.4 d, P = 0.002). Hospitalization costs appeared lower but did not differ statistically ($59,419 vs $159,353, P = 0.12). In nonoperative cases, LOS was shorter if an MRI occurred within 48 hours of admission (7.3 vs 10 d, P = 0.03). Disease recurrence was not associated with MRI timing.

Conclusion: Overall, children with BJI who underwent MRI scans before surgery had lower reoperation rates. Children receiving MRIs within 48 hours of admission had shorter LOS.

儿童骨与关节感染高级成像的最佳时机。
目的:儿童骨与关节感染(BJI)治疗中的先进成像技术有望改善疾病预后。有关手术和非手术治疗骨与关节感染的最佳磁共振成像(MRI)时机的知识十分有限。本研究探讨了磁共振成像时机对儿童 BJI 的手术次数、住院时间(LOS)、住院费用和疾病复发的影响:这是一项回顾性研究,研究对象为2018年至2023年在奥克兰地区接受治疗的16岁以下急性血源性骨髓炎(AHO)或化脓性关节炎(SA)患者。作为诊断工作的一部分,接受核磁共振成像检查的病例也包括在内。对治疗方法、入院与核磁共振成像之间的间隔时间、住院时间、住院费用和感染复发情况进行了评估:共有 563 例 BJI 病例,其中 390 例符合纳入标准。病例主要为 AHO(85%)。有 MRI 的病例比例随着时间的推移从 54%(2018 年)增加到 80%(2023 年)。骨膜下脓肿或邻近化脓性关节炎等局部播散性感染占 48%。术前(n = 145)与术后 MRI(n = 60)的患儿再次手术率较低(33% vs 77%,P = 0.001),住院时间较短(14.1 d vs 22.4 d,P = 0.002)。住院费用似乎较低,但没有统计学差异(59,419 美元 vs 159,353 美元,P = 0.12)。在非手术病例中,如果在入院后 48 小时内进行核磁共振成像检查,住院时间会缩短(7.3 天 vs 10 天,P = 0.03)。疾病复发与核磁共振成像时间无关:结论:总体而言,在手术前接受核磁共振成像扫描的BJI患儿再手术率较低。在入院 48 小时内接受 MRI 检查的患儿的 LOS 更短。
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来源期刊
CiteScore
3.30
自引率
17.60%
发文量
512
审稿时长
6 months
期刊介绍: ​Journal of Pediatric Orthopaedics is a leading journal that focuses specifically on traumatic injuries to give you hands-on on coverage of a fast-growing field. You''ll get articles that cover everything from the nature of injury to the effects of new drug therapies; everything from recommendations for more effective surgical approaches to the latest laboratory findings.
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