DOI: http://dx.doi.org/10.18203/issn.2454-2156.IntJSciRep20180794

Primary patellar osteomyelitis presenting as a pre-patellar bursitis in children: a potential diagnostic mistake

Rajib Naskar, Santosh Bindumadhavan, Rishabh Jaiswal, Harshad Argekar

Abstract


A 14-year-old male presented with pain and swelling of left knee since 15 days with history of non-significant trauma and mild fever. On clinical examination there was raised superficial skin temperature and pre-patellar effusion with positive patellar tap. Haematological investigations show moderate leucocytosis and raised acute phase reactants, with an unremarkable radiography. Under the impression of infective pre-patellar bursitis, patient was posted for arthrotomy, debridement and wound wash. Post-operative broad spectrum antibiotics started. 2 weeks after surgery the swelling reappears, when an advanced imaging was offered which shows osteomyelitic changes in upper pole of patella. After 6 weeks of intravenous antibiotics and conservative management, the lesion was healed leaving no sequel.

 


Keywords


Patellar osteomyelitis, Pre-patellar bursitis, Knee swelling, Children

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References


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