Osteomyelitis of the Odontoid Process in Children: Two Cases and Review of the Literature.

OBJECTIVE

To report clinical, laboratory and radiologic manifestations in 2 infants with osteomyelitis of the odontoid process (dens).

BACKGROUND

Vertebral osteomyelitis is uncommon, and osteomyelitis of the dens has rarely been reported in the pediatric population.

METHODS

The medical records of 2 infants diagnosed with dens osteomyelitis were reviewed.

RESULTS

Both infants had fever, which resolved spontaneously before admission. Both were nontoxic appearing with persistent neck stiffness and torticollis. White blood count and C-reactive protein were only mildly elevated in both cases. Blood cultures were sterile. Magnetic resonance imaging revealed the diagnosis. They both fully recovered.

CONCLUSIONS

We report 2 cases of dens osteomyelitis. These cases emphasize the need to consider C1-C2 osteomyelitis in the differential diagnosis of neck stiffness and torticollis.