Nonspinal tuberculous osteomyelitis in children

Tuberculous osteomyelitis is uncommon in children but its incidence Seems to have increased in our hospital; recently. From; April:! 1984 to December 1994, we treated 12 children with this problem.? Three cases were diagnosed in the first 7 years ::and nine cases in uhe latter 4 years. Primary spinal lesion was excluded, There were seven bo!a and five girls, with an average age of 2.4 years (range 1-4.5). Anatomic sites of of involvement were distal femur in three patients, proximal tibia in three, foot in three, proximal! femur in one; proximal humerus ill one, Fr;proximal radius in one, distal radius in one, and rib in one, Except for one case of hip lesion, the most common symptom was localized swelling. Delay in; diagnosis was 6.6 months on average. The diagnosis was confirmed bacteriologically or histologically? In all patients after surgical debridement and curettage. Anti-tuberculosis (TB) drugs were administered for 6 months postoperatively.,;All patients were :fc?followed-up for an average of 3.8 I;ears (range 2-8) with satisfactory healing of their tuberculous lesions: Two cases were complicated with physeal bar formation., One patient had residual flexion ;contracture of the knee.; Although the mortality!: fr-om TB has decreased in Taiwan, the frequently reported late cases of TB deserve attention. Physicians should be aware that TB remains an important cause of bone lesions. These lesions can be healed by combined therapy with surgical debridement and anti-TB;; medication for 6 months.