8-year-old boy with history of chronic pain of right knee



Doctor's Information

Name : Ali Asghar, Abbas
Family :Halimi Asl, Momenzadeh
Affiliation : Pediatric Department,Shohada Tajrish Hospital,SBMU
Academic Degree: Assistant Professor of Pediatric
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Amir Hossein Hosseini


Patient's Information

Gender : Male
Age : 8


Case Section

Muskuloskeletal System


Clinical Summary

8-year-old boy with history of chronic pain of right knee



Imaging Procedures and Findings

Lateral and anteroposterior radiographs of right knee show chain of antibiotic (Gentamycin)-impregnated beads threaded onto a wire and positioned into distal part of right femur for treatment of chronic osteomyelitis.



The placement of antibiotic-impregnated beads at the site of chronic osteomyelitis is a valuable adjuvant therapy to surgical débridement in the eradication of infection and offers the additional advantage of allowing primary wound closure, which reduces the incidence of nosocomial infections and decreases the requirement for nursing care. In addition, cement beads are of value in the treatment of pedal osteomyelitis in patients with diabetes. Since its introduction in 1970, antibiotic-impregnated cement has proven to be an invaluable tool for local antibiotic delivery, and its use has now spread outside the field of orthopedic surgery. Although the radiologic appearances of antibiotic-impregnated polymethyl methacrylate (PMMA) and regular PMMA are identical, peculiarities in the position and morphology of antibiotic-impregnated cement usually enable the radiologist to differentiate between the two. Its presence indicates one of two things: Either infection was present at the time the PMMA cement was inserted, or there was a high potential for the development of local sepsis, such as in cases of an open fracture. On the basis of this finding, the radiologist should carefully search for evidence of osteomyelitis.


Final Diagnosis

inserted antibiotic(Gentamycin)-impregnated beads and the corresponding wire for the treatment of chronic osteomyelitis



Heffernan EJ, Alkubaidan FO, White LM. The Radiology of Antibiotic-Impregnated Cement. AJR. 2007; 189:446â??454.


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