Imaging on pelvic pyomyositis in children related to pathogenesis

J Child Orthop. 2009 Dec;3(6):479-84. doi: 10.1007/s11832-009-0206-5. Epub 2009 Oct 6.

Abstract

Purpose: Pelvic pyomyositis in children is a rare infectious condition, although it is increasingly reported in temperate climates. Often considered a primary disease, new diagnostic methods are able to identify additional foci of infection. The purpose of this study is to review our patients and to analyze the imaging studies to determine its pathogenesis.

Methods: A retrospective study of the clinical charts and imaging records of 11 patients was made, noting the number and location of muscles involved, as well as bone and joint involvement.

Results: Besides the classical form of pelvic pyomyositis, i.e., iliopsoas pyomyositis, other muscular groups were frequently affected, often with multiple involvement. Bone involvement is also frequent. Magnetic resonance imaging (MRI) gives the most useful information.

Conclusion: MRI is the diagnostic procedure of choice for diagnosing pelvic pyomyositis in children. It may also have an elucidating role in the debated pathogenesis of this condition. In most of the cases, pelvic pyomyositis in children could be secondary.