Discitis versus vertebral osteomyelitis
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The clinical distinction between
discitis and vertebral osteomyelitis may be difficult or impossible.
Data from 50 children treated at the children's hospital in Houston,
Texas between 1980 and 1998 have been reviewed (Marisol Fernandez and
colleagues. Pediatrics
2000;105: 1299-304). Of the 50 children, 36 had discitis and 14 vertebral osteomyelitis. Children with
discitis were often younger (mean age 2.8 years, range 0.7-16 years)
than those with osteomyelitis (mean 7.5 years, range 2-13 years) and had had symptoms for a shorter time (22 days
v 33 days). In both groups the usual
symptoms were refusal to walk, limp, or back pain but those with
osteomyelitis often appeared more ill and were more often febrile (79%
v 28%). These authors dismiss
radionucleotide bone scans and computed tomography as providing
non-specific information and concentrate on plain radiography and
magnetic resonance imaging. Plain x rays of
the spine were performed on 33 patients with discitis and were regarded
as diagnostic in
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