Ultrasound Localization of Subperiosteal Abscesses in Children with Late-Acute Osteomyelitis

Ultrasonography was undertaken in nine children with late presenting acute osteomyelitis, in four children with typical superficial cellulitis, and in four with a soft tissue abscess. Ultrasound distinguished between superficial cellulitis, soft tissue abscess, and subperiosteal abscess. The abscesses were confirmed at operation, and a subperiosteal abscess was also detected in the child with deep periosseous cellulitis. Ultrasonography was particularly useful in confirming the existence of a subperiosteal abscess and in localizing it precisely in children with diffuse swelling and tenderness of a limb owing to late-acute osteomyelitis. Surgical drainage of pus can be avoided in patients without ultrasound features of an abscess and can be better planned in those who require it.