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The PIC Bone Study

Imaging in Paediatric Osteomyelitis: a multi-centre cohort study to understand the role of MRI and Ultrasound in the diagnosis of acute haematogenous osteomyelitis in children.

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When a child is brought to the emergency department with a painful limb without an obvious injury, doctors are typically faced with a dilemma between two diagnoses:

  • A serious, though relatively uncommon, infection of their bones or joints OR
  • A non-serious, though common, temporary swelling to their joints

Serious infections in bones are rare, but can be limb and life threatening. They require urgent treatment (antibiotics) and sometimes surgery. Temporary joint swelling however, is common and resolves without any intervention within a few days. The challenge is to quickly identify which child has an infection and which has joint swelling. Telling these apart is often not easy and involves x-rays and blood tests. Often, ‘special tests’ are also used, which are ultrasound and/or MRI (magnetic resonance imaging) scans. Doctors around the world are unsure about the best choice of test, particularly the ‘special tests’, and in what order tests should be performed when a bone infection is suspected.

A clear pathway outlining which tests to perform, and when they are needed, would help to ensure that bone infections are not missed. This would also reduce unnecessary tests on children who do not have an infection.

Taking Part

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About the Study

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Contact Us

Get in touch with the study team

PICBONE study logo

Botnar Research Centre
University of Oxford
Windmill Road


01865 613460

PIC Bone is funded by the National Institute for Health and Care Research (Award ID: NIHR134125 ). The views expressed are those of the authors and are not intended to be representative of the views of the funder, sponsor or other participating organisations.

The information contained in this website is for general information about the PIC Bones study and is provided by the University of Oxford (Surgical Intervention Trials Unit).

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