J Korean Orthop Assoc.  2009 Dec;44(6):686-690. 10.4055/jkoa.2009.44.6.686.

Osteomyelitis due to Nontuberculous Mycobacterium in Immunocompetent Children: Report of Two Cases

• Bae JY
• Choi IH
• Kim JR

• KMID: 2186297
• DOI: http://doi.org/10.4055/jkoa.2009.44.6.686

Abstract

Osteomyelitis caused by nontuberculous mycobacterium (NTM) is rare in immunocompetent children, and is often difficult to differentiate from a bone tumor, juvenile rheumatoid arthritis, soft-tissue inflammation and subacute osteomyelitis. We report NTM osteomyelitis in immunocompetent children that developed at the left distal femoral epiphysis in a 24-month-old boy and at both tali in a 7-year-old boy.

Keyword

Nontuberculous mycobacterium; Osteomyelitis

MeSH Terms

Arthritis, Juvenile Rheumatoid
Child
Epiphyses
Humans
Inflammation
Nontuberculous Mycobacteria
Osteomyelitis
Preschool Child

Figure

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  Fig. 1 Case 1. Plain radiograph shows radiolucent lesion with some irregularity at the distal femoral epiphysis and mild soft tissue swelling around distal thigh.

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  Fig. 2 Case 1. Contrast enhanced T1-weighted MR images show bony lesion with enhancement at the distal femoral epiphysis.

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  Fig. 3 Case 1. Plain radiographs. (A) At 3 months after latest operation. Well-defined osteolytic lesion at left distal femur metaphysis and epiphysis. (B) 9 months after latest operation. Showing a sclerotic demarcation. (C) 18 months after latest operation. Well healing status of osteomyelitis without an evidence of recurrence.

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  Fig. 4 Case 2. Plain radiographs show destructive bony lesion in both talus and calcaneus with ankle joint swelling. Plain radiographs of the right (A, C) and left ankle (B, D).

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  Fig. 5 Case 2. Contrast enhanced T1-weighted MR images show bone marrow signal change at the right talus and calcaneus with enhancement and joint effusion with strong enhancement of synovial membrane.

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