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My ds 15 -- osteomyelitis? periostitis?


Kate in Arabia
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I had never heard either of these terms until today.  Last night my ds complained of leg pain.  He wasn't loud about it, I generally let these things sit a bit.  I let it sit until this morning, he was still complaining and saying it hurt when he walked.  When I sat him down to get a proper look, the entire front of his lower leg was swollen super-tight.  And when I touched it it was burning hot.  No redness, no cut, no bite mark, no nothing; other than the swelling, it looked like his other leg.  And he couldn't think of anything he had done to hurt his leg, or anything that might have hit or injured his leg, it just spontaneously started hurting.

 

The heat and swelling concerned me so we headed to the er; the er forwarded us to an orthopedist, who had an x-ray taken (came back clear), blood drawn and placed a request for an mri.  We're still waiting for insurance approval for the mri, but I noticed on his notes sheet that the dr wrote: "osteomyelitis? periostitis?"  He put ds on antibiotics and some other drugs to hopefully reduce the swelling and the pain while we wait for some answers.

 

Has anyone dealt with this kind of thing before?  I have never seen anything like it.  It looks and feels like a really bad infection, but without the redness or central point of injury, kwim?  I kept looking for a bite, like a scorpion or spider, but wouldn't there be redness at the site?

 

Confused and concerned... 

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I asked about the blood clot and was told that the swelling would be more on the back of the leg, whereas this is all on the front (is that wrong?).  And for cellulitis, just from what I've read isn't there redness with that?  He has no redness at all.  I just looked at it again, it's still just really tight and warm.  And hurts when I touch it.  Weird.

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We went through a big scare last year when my daughter had sudden leg pain (but no swelling). Her xray showed what looked like a large tumor, though. Her MRI was even more detailed. She had surgery to biopsy it and clean it out, and they could not conclude what it was. It wasn't obviously a tumor and nothing grew in cultures, so it wasn't obviously an infection - they called it a "bone defect". She had a second surgery to do a bone graft and install a metal plate over the defect, plus a round of oral antibiotics to be safe.

 

I guess you didn't need that much info ... but in her case the x-ray and MRI were both pretty detailed. So I would be very encouraged that the x-ray was clear, and would look forward to the MRI for even better reassurance.

 

Is it around the ankle joint? Would a torn ligament cause those symptoms? Did they mention arthritis?

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Thanks Chaya (and thanks everyone who's posted)... I'm hopeful we'll get some answers tomorrow.  At least the blood test results will be back and we will hopefully either have a clue what it is or rule something out, kwim?  The insurance company is already dithering a bit on authorizing the mri, I don't know how fast all of that can get settled.

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Osteomelitis is a type of bone infection. My Dad had it.  They managed his as a chronic condition with antibiotics but if he would have been younger they would have performed surgery to cure it.  I have had a blood clot that the doctors first thought was cellulitis and yes it was on the front of my leg but in the greater saphenous vein which is not a major vein so not life threatening as one in a major vein would be.  My blood clot presented as red and hot with some swelling and very painful when walking.  It didn't bother me much when I was off my feet.  One of the first things the doctors did was mark me with a marker where the red ended or in your case the swelling so they would have a point of reference to see if it was spreading and if their treatment was being effective.  I hope you get clearance for the MRI real soon.  I know the waiting can be scary. 

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My DD had a small benign tumor called an osteo osteoma. Pain is the primary symptom and the pain is very responsive to nsaids like Advil.  

(This is when we found out she is allergic to motrin/nsaids but that is another story) They are very rare, more likely in boys in their second decade of life. It was quite unusual for my DD to have one.  MRI will see it.  She did have a marked temperature difference from the other leg and tenderness. It was in her fibula. They do not get bigger than 2cm but 2cm is big in a kid's bones. 

 

Once we knew what it was the treatment was it was relatively simple. Radio frequency ablation was performed. Within a week she was feeling just about back to normal. She has a small dot on her leg.

 

I hope and pray that you get an answer soon.  Here is a link I found helpful.  They most often happen in the legs abut can happen anywhere in the body

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Well today we were still dealing with insurance red tape.  Blood tests came back normal.  His leg was better in the morning, but as the day wore on got worse.  It's now swollen, hot, and turning red.  This really does not sound like a good sign to me.  I talked to the dr, and he said aside from bringing him in for an iv antibiotic, there isn't much to do until he gets authorization from the insurance company.  So I'm supposed to keep on with the meds he has, and call him in the morning to update (it's 6 pm here now).

 

 

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Well today we were still dealing with insurance red tape. Blood tests came back normal. His leg was better in the morning, but as the day wore on got worse. It's now swollen, hot, and turning red. This really does not sound like a good sign to me. I talked to the dr, and he said aside from bringing him in for an iv antibiotic, there isn't much to do until he gets authorization from the insurance company. So I'm supposed to keep on with the meds he has, and call him in the morning to update (it's 6 pm here now).

(((Kate))) I'm sorry.

 

I'm sending good thoughts!

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My husband had Osteomyelitis which was an infection which settled in his hip bones. He was a 25yr old healthy male with no known injury. His was caused by staph infection aureus. It took them months to diagnose and he ended up in hospital for a couple of weeks, one to diagnose, one to treat. For him they put him on IV drug therapy for six weeks, then pills for six months. His was very, very advanced since it took them so long to figure out what was wrong (started taking him to ER and doctors in May, ended up in hospital in July).

 

Friends child had similar infection and they did emergency surgery and then antibiotics for several weeks.

 

Neither dh nor dd's friend have long term problems. Once healed they are fine.

 

Hope you get answers soon and started on treatment.

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We just got back from the hospital and ds' mri.  Final diagnosis is cellulitis.  The mri showed that the inflammation is all in the area between the fat and muscle layers; so no bone involvement, no tumor or blood clot, no pus, etc.  We don't know how it got started, it looks like there are many possibilities (bug bite/sting, small cut, etc.).

 

The dr said that he can see the swelling has spread to his ankle and foot, but since overall the swelling seems less intense, and the pain and heat is less (although still there), we can continue with oral antibiotics and the other meds he prescribed.  If in the next day or two he is not showing marked improvement he will have to be admitted to the hospital for iv antibiotics for 2-3 days (!).

 

Thanks again for everyone's input, it really actually is helpful to have some chatter about it, kwim?

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