Article Text

PDF
The toddler refusing to weight-bear: a revised imaging guide from a case series
  1. O J Arthurs1,
  2. A C Gomez1,
  3. P Heinz2,
  4. P A K Set1
  1. 1
    Department of Radiology, Addenbrooke’s Hospital, Cambridge, UK
  2. 2
    Department of Emergency Medicine, Addenbrooke’s Hospital, Cambridge, UK
  1. Correspondence to Dr P Set, Department of Radiology, Box 219, Addenbrooke’s Hospital, Cambridge University Teaching Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK; p.set{at}addenbrookes.nhs.uk

Abstract

Background: The previously mobile child who refuses to walk or weight-bear is a common presentation to the accident and emergency department, for which there are a number of causes. One uncommon cause is discitis, an inflammatory process of the intervertebral disc, which is easily diagnosed with spinal magnetic resonance imaging (MRI). A case series of three patients is presented of non-weight-bearing children in whom there was a delay in making the diagnosis of lumbosacral discitis. None presented with back pain, spinal symptoms or abnormal neurological findings, and a full range of movement of both hips was found.

Methods: All patients underwent conventional radiography and ultrasound, but diagnoses were made on spinal MRI, with two patients undergoing bone scintigraphy before this.

Results: The mean delay was 15.6 days (range 13–20) from presentation at the hospital to MRI. All three patients made a good clinical recovery with intravenous antibiotics.

Conclusion: These cases are presented in order to heighten the awareness of this disease entity and its imaging findings, and suggest new guidelines for the appropriate radiological investigations in this clinical setting.

Statistics from Altmetric.com

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.