Authors :
Sabin Yadav; Naveed Ahmed; Clare Carpenter
Volume/Issue :
Volume 9 - 2024, Issue 11 - November
Google Scholar :
https://tinyurl.com/2w23sf57
Scribd :
https://tinyurl.com/4jk8pbvz
DOI :
https://doi.org/10.5281/zenodo.14280664
Abstract :
Osteomyelitis of the carpal bones is a rare
condition and most commonly occurs in cases of
penetrating injury. We report a case of an eleven-month-
old boy who presented with a vague history of trauma
and not actively using his right hand. No bony changes
were noted on the X ray. The Patient was brought in
again 5 days later with the same complaints during
which examination revealed grossly restricted movement
of the right wrist, a repeat X-ray raised the suspicion of
some lysis on the hamate which was later confirmed by
ultrasound. MRI confirmed osteomyelitis of the distal
end of the hamate with additional finding of involvement
capitate and fluid in the carpal tunnel. He then
underwent right carpal tunnel decompression. Blood
cultures grew gram-negative coccobacillus. However,
there was no growth from the sample from the wrist. He
was treated with IV antibiotics in the hospital which was
switched to oral antibiotics. (Total 4 weeks duration).
He was followed up for 1 year with repeat x-rays
which were normal and he has had a full recovery.
This case highlights the importance of considering
osteomyelitis as a differential diagnosis even in the
absence of trauma.
References :
- Copeland R, Blanchard E, Saito P. A Rare Case of Carpal Osteomyelitis in a Spinal Cord Injury Patient: A Case Report. Cureus. 2023;15(3):e36283. Published 2023 Mar 17. doi:10.7759/cureus.36283
- Conterno LO, Turchi MD. Antibiotics for treating chronic osteomyelitis in adults. Cochrane Database of Systematic Reviews 2013, Issue 9. Art. No.: CD004439. DOI: 10.1002/14651858.CD004439.pub3.
- McDonald LS, Bavaro MF, Hofmeister EP, Kroonen LT. Hand infections. J Hand Surg Am. 2011;36(8):1403-1412. doi:10.1016/j.jhsa.2011.05.035
- Pinder R, Barlow G. Osteomyelitis of the hand. Journal of Hand Surgery (European Volume). 2016;41(4):431-440. doi:10.1177/1753193415612373
- Jaramillo D. Infection: musculoskeletal. Pediatr Radiol 2011;41 Suppl 1:S127-34. 10.1007/s00247-011-2001-y [PubMed] [CrossRef] [Google Scholar] [Ref list]
- Lee YJ, Sadigh S, Mankad K, Kapse N, Rajeswaran G. The imaging of osteomyelitis. Quant Imaging Med Surg. 2016; 6(2): 184-198. doi:10.21037/qims.2016.04.01
Osteomyelitis of the carpal bones is a rare
condition and most commonly occurs in cases of
penetrating injury. We report a case of an eleven-month-
old boy who presented with a vague history of trauma
and not actively using his right hand. No bony changes
were noted on the X ray. The Patient was brought in
again 5 days later with the same complaints during
which examination revealed grossly restricted movement
of the right wrist, a repeat X-ray raised the suspicion of
some lysis on the hamate which was later confirmed by
ultrasound. MRI confirmed osteomyelitis of the distal
end of the hamate with additional finding of involvement
capitate and fluid in the carpal tunnel. He then
underwent right carpal tunnel decompression. Blood
cultures grew gram-negative coccobacillus. However,
there was no growth from the sample from the wrist. He
was treated with IV antibiotics in the hospital which was
switched to oral antibiotics. (Total 4 weeks duration).
He was followed up for 1 year with repeat x-rays
which were normal and he has had a full recovery.
This case highlights the importance of considering
osteomyelitis as a differential diagnosis even in the
absence of trauma.
