Pediatric Patients with Osteomyelitis and/or Septic Joint Undergoing Surgical Debridement Have Equivalent Short-Term Outcomes with or without Preoperative MRI
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, underw...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-03-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/11/3/300 |
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| author | E. Graham Englert Collin L. Braithwaite Maria E. Aguirre-Flores Aaron W. Lam Mohamed Sarraj Abigail Kumagai E. Dimitra Bednar Adam M. Gordon Ibrahim Salama Jacob Keeley Indu Pathak Waleed Kishta Ahmed M. Thabet Amr Abdelgawad Ehab Saleh |
| author_facet | E. Graham Englert Collin L. Braithwaite Maria E. Aguirre-Flores Aaron W. Lam Mohamed Sarraj Abigail Kumagai E. Dimitra Bednar Adam M. Gordon Ibrahim Salama Jacob Keeley Indu Pathak Waleed Kishta Ahmed M. Thabet Amr Abdelgawad Ehab Saleh |
| author_sort | E. Graham Englert |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-24T18:26:33Z |
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| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-04-24T18:26:33Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-2b9b79b7a60543b1a9b7e3a78ee12e8a2024-03-27T13:31:03ZengMDPI AGChildren2227-90672024-03-0111330010.3390/children11030300Pediatric Patients with Osteomyelitis and/or Septic Joint Undergoing Surgical Debridement Have Equivalent Short-Term Outcomes with or without Preoperative MRIE. Graham Englert0Collin L. Braithwaite1Maria E. Aguirre-Flores2Aaron W. Lam3Mohamed Sarraj4Abigail Kumagai5E. Dimitra Bednar6Adam M. Gordon7Ibrahim Salama8Jacob Keeley9Indu Pathak10Waleed Kishta11Ahmed M. Thabet12Amr Abdelgawad13Ehab Saleh14Department of Orthopaedic Surgery, Beaumont Hospital Royal Oak, Royal Oak, MI 48073, USADepartment of Orthopedic Surgery, Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USADepartment of Pediatrics, Texas Tech University Health Sciences Center, El Paso, TX 79905, USADepartment of Orthopedic Surgery, Maimonides Medical Center, Brooklyn, NY 11219, USADivision of Orthopaedic Surgery, McMaster University, Hamilton, ON L8S 4L8, CanadaDepartment of Ophthalmology and Visual Sciences, The Ohio State University College of Medicine, Columbus, OH 43210, USADepartment of Medicine, University of Toronto, Toronto, ON M1C 1A4, CanadaDepartment of Orthopedic Surgery, Maimonides Medical Center, Brooklyn, NY 11219, USAPaul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USADepartment of Orthopedic Surgery, Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USADepartment of Pediatrics, Texas Tech University Health Sciences Center, El Paso, TX 79905, USADivision of Orthopaedic Surgery, McMaster University, Hamilton, ON L8S 4L8, CanadaDepartment of Orthopaedic Surgery, Texas Tech University Health Sciences Center, El Paso, TX 79905, USADepartment of Orthopedic Surgery, Maimonides Medical Center, Brooklyn, NY 11219, USADepartment of Orthopaedic Surgery, Beaumont Hospital Royal Oak, Royal Oak, MI 48073, USAThe 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.https://www.mdpi.com/2227-9067/11/3/300MRIseptic arthritisosteomyelitispediatric |
| spellingShingle | E. Graham Englert Collin L. Braithwaite Maria E. Aguirre-Flores Aaron W. Lam Mohamed Sarraj Abigail Kumagai E. Dimitra Bednar Adam M. Gordon Ibrahim Salama Jacob Keeley Indu Pathak Waleed Kishta Ahmed M. Thabet Amr Abdelgawad Ehab Saleh Pediatric Patients with Osteomyelitis and/or Septic Joint Undergoing Surgical Debridement Have Equivalent Short-Term Outcomes with or without Preoperative MRI Children MRI septic arthritis osteomyelitis pediatric |
| title | Pediatric Patients with Osteomyelitis and/or Septic Joint Undergoing Surgical Debridement Have Equivalent Short-Term Outcomes with or without Preoperative MRI |
| title_full | Pediatric Patients with Osteomyelitis and/or Septic Joint Undergoing Surgical Debridement Have Equivalent Short-Term Outcomes with or without Preoperative MRI |
| title_fullStr | Pediatric Patients with Osteomyelitis and/or Septic Joint Undergoing Surgical Debridement Have Equivalent Short-Term Outcomes with or without Preoperative MRI |
| title_full_unstemmed | Pediatric Patients with Osteomyelitis and/or Septic Joint Undergoing Surgical Debridement Have Equivalent Short-Term Outcomes with or without Preoperative MRI |
| title_short | Pediatric Patients with Osteomyelitis and/or Septic Joint Undergoing Surgical Debridement Have Equivalent Short-Term Outcomes with or without Preoperative MRI |
| title_sort | pediatric patients with osteomyelitis and or septic joint undergoing surgical debridement have equivalent short term outcomes with or without preoperative mri |
| topic | MRI septic arthritis osteomyelitis pediatric |
| url | https://www.mdpi.com/2227-9067/11/3/300 |
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