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            [0] => Diagnostic Performance of Inflammatory Markers in Acute Osteomyelitis in Children
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    [etablissement] => Array
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            [0] => CHU Fattouma Bourguiba Monastir
        )

    [nom] => Array
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            [0] => Abid
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    [prenom] => Array
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            [0] => Said
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            [0] => Saidabid94@gmail.com
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            [0] => 
 
Nom prénom / Name Surname: Jacem Saadana, Firas Chaouech, Said Abid, Moez Jalleli, Firas Boughattas, khouloud khemili, Amine Sioud, Aymen Fekih, Abderrazek Abid
Email: 
Hôpital / Hospital: CHU Fattouma bourguiba monastir

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            [0] => 3663
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            [0] => 1
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    [user_email] => Array
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            [0] => Saidabid94@gmail.com
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    [specialite] => Array
        (
            [0] => Chirurgie orthopédique et traumatologique
        )

    [pays] => Array
        (
            [0] => Tunisie
        )

    [texte_abs] => Array
        (
            [0] => Introduction: Osteomyelitis, pathologically defined as an infection of bone and bone marrow caused by microbial agent. It is a significant consideration in cases of febrile limping in children. While mastery of clinical presentations is crucial, our study focuses on analyzing the diagnostic performance of inflammatory markers to guide diagnostic orientation and management strategies.

Objective: Analysis of the sensitivity and specificity of inflammatory markers in the diagnosis of acute osteomyelitis in children.

Materials and Methods: This retrospective study includes all patient records admitted to the Orthopedic Department of Monastir for acute osteomyelitis over an 8-year period (January 1, 2015, to December 31, 2022). All patients underwent clinical examination, laboratory tests, and diagnostic radiological assessment. Data was collected using a predefined form.

Results: The study involved 50 children hospitalized for osteomyelitis. The mean age was 8.48 ± 3.864 years, ranging from 1 to 20 years. There was a male predominance with 34 boys (68%) and 16 girls (32%). Ten patients had relevant medical and/or surgical histories (20%). Twenty-one patients (42%) received some form of medical treatment before admission, including analgesics (n=16; 32%), anti-inflammatories (n=5; 10%), and oral antibiotics (n=8; 16%). The general condition was preserved in 43 cases (86%) and altered in 7 cases (14%) upon admission. Fever was present in 42 patients (84%) at admission. The sensitivity and specificity for leukocytosis (≥11,000 cells/ml), CRP (≥20 mg/l), and erythrocyte sedimentation rate (ESR) (≥20 mm at the 1st hour) were 53.3%, 84.4%, and 97.78%, and 40%, 20%, and 20%, respectively. At admission, standard radiography revealed abnormalities in 40% of cases, while ultrasound detected abscesses in 38% of cases.

Conclusion: Although inflammatory markers, especially C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), are useful tools to support the diagnosis of osteomyelitis, they should not be considered definitive indicators due to variations in sensitivity and specificity. Diagnosis primarily relies on clinical elements, considering that different pathogens can lead to varying levels of inflammation
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