骨端線に限局していると思われた踵骨血行性骨髄炎の1例

抄録

Hematogenous osteomyelitis of the calcaneus is uncommon. We describe a rare case of hematogenous osteomyelitis localized in the growth plate of the calcaneus and review the literature.
The patient was a 10-year-old boy who complained of right heel pain. He had fallen from a height of 6 feet 6 inches two days before, but had no wound. When admitted to our hospital, his temparature rose to 39°C. Examination of his right heel demonstrated moderate swelling and local tenderness over the medial side of the calcaneus. Laboratory tests showed WBC count 5, 500/mm³, CRP 0.86mg/dl and ESR 46mm/hr. Initial radiographs showed no evidence of bony abnormality. Computed tomography revealed a slight expansion in the medial growth plate of the calcaneus.
We aspirated pus from his heel, which on culture grew Staphylococcus aureus. Surgical curettage was performed, and the pus was proved to be localized in the growth plate of the calcaneus.
Seven months after treatment, he was clinically and radiologically well.