Osamu Miyazaki

Department of Radiology, National Center for Child Health and Development

　　This review article includes the imaging of several major categories of pediatric skeletal emergency radiology. Acute osteomyelitis and septic arthritis commonly occur together, because metaphyseal and epiphyseal vessels are connected by transphyseal vessels. Because of this, osteomyelitis originating in the metaphysis easily spreads into the epiphysis. Radiographically, deep soft tissue edema is the only abnormal finding of acute osteomyelitis on initial study. Bone destruction and periosteal reaction are not demonstrated before 10 to 14 days. MRI and ultrasonography are useful for early diagnosis of acute osteomyelitis in children. Bones in children are soft and the epiphyses are not fused, fractures are different from those seen in adults. There are some characteristic pediatric fractures in long bones, such as plastic bending fracture, torus fracture, and classic greenstick fracture. Also, it is important to recognize physical injury ; Salter-Harris classification is widely used for proper treatment and prognostication. Other specific injury such as toddler’s fractures and stress fractures are discussed. These categories discussed herein are basic and important for daily radiological practice.

Keywords：Child，Osteomyelitis，Fracture，Plain film，MRI