We reviewed the diagnostic and clinical experience with acute osteomyelitis of the pelvis at Tauranga and Waikato Hospitals.

A retrospective review from a prospectively maintained data base was undertaken looking at all cases of pelvic osteomyelitis between 1988 and February 2003 at the two hospitals. Analysis of the diagnostic pathways, time to diagnosis, blood parameters, organism isolation, and type of imaging was carried out. Subsequent treatment including duration of intravenous antibiotic use was correlated with patient outcome.

There were 15 cases of acute pelvic osteomyelitis treated with an average patient age of 11.9 years. The most common causative organism isolated was Staphylococcus Aureus (S. Aureus) with no cases of MRSA. Inflammatory markers (ESR and CRP ) were elevated in the majority of patients but 75% had a normal white cell count. Blood cultures were positive in 90% of cases.3 patients required surgical drainage ( 1 case of turberculosis, 2 cases of staphylococcus aureus) The average duration of intravenous antibiotic therapy was 10 days with subsequent oral therapy for an average of 4 weeks. The minimum patient follow up was for 3 months, and there was no reoccurrence of infection in any patient. At final review all patients had returned to normal activities

Staphylococcus aureus is the most common causative agent in this population. ESR and CRP are the most useful markers and blood cultures are essential. Most cases can be managed non surgically and a shorter course of intravenous antibiotic therapy in this group was not associated with any adverse outcomes or reoccurrences of infections

Thirteen patients with dyschondrosteosis from eight families are reviewed and their clinical and radiographic variation noted. Inheritance is likely to be autosomal dominant but with only 50 per cent penetrance. Stature was moderately reduced, due to shortening of the bones of the leg. Radio-ulnar shortening could either involve both bones equally or the radius predominantly, in which case a typical Madelung deformity was seen. Tibio-fibular disproportion was present in half the patients, two of them having severe deformity associated with tibia varum and a long fibula. The treatment of one of these patients is described. It is recommended that patients with dyschondrosteosis should be kept under surveillance during the growing period. Problems in the limbs, especially the legs, may require operations to equalise the length of the two bones.