Zusammenfassung
Das muskuloskelettale System unterliegt im Verlauf des Wachstums wie kaum ein anderes
Organsystem einem hohen Wandel. Entsprechend unterscheiden sich Entzündungen in Ausdehnung
und Verlauf bei Kindern und Jugendlichen nicht nur von denen bei erwachsenen Patienten,
sondern verändern sich auch während der Adoleszenz.
Abstract
Infectious diseases of the musculo-skeletal system present differently in patients
of different age groups. Due to the development of anatomical structures during growth
different area of the skeletal system can be affected by infectious diseases. Inflammations
can be limited to specific tissues (bone, muscles, tendons) to certain areas (joints,
epiphyseal bone, vertebrae) or present as systemic inflammatory diseases.
Ultrasound and MRI are the primary diagnostic tools, depending on the underlying diagnosis.
US is easily available and can give valuable information specially about superficial
structures. US investigations can path the way of further diagnostic steps and can
therefore limit unnecessary diagnostic procedures. MRI is the most valuable tool to
visualize infections in muscles, joints and vertebrae. Whole body MRI becomes more
and more available and should replace szintigraphy due to the absence of radiation
and is helpful in primary diagnosis and during follow-up. The use of CT is limited
to special indications like percutaneous biopsies. A plain x-ray of the affected bone
is helpful as baseline and follow-up. It needs only a small amount of radiation and
can provide information about bone structure and long term changes of bone formation.
Young children are most frequently affected by haematogenous infections or by direct
infections after traumata and present predominantly in an acute way. In adolescents
non-bacterial, chronic, autoimmune disorders are more frequent.
Diagnosis of infectious diseases is important because they can mimic malignant disorders
and can cause irretrievable destruction of skeletal structures. In addition, chronic
infections often present with unspecific clinical symptoms like in the case of a spondylodiscitis
and should therefore be considered if no other diagnosis can be proven.
Schlüsselwörter
muskuloskelettales System - Entzündungen - Kinder - Jugendliche
Key words
musculoskeletal system - infection - inflammation - children - young people - osteomyelitis
- spondylodiszitis
