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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How To Treat Compression Fracture?

My 10 yr. old daughter has a T5 compression fracture caused by a lesion of unknown origin. Two biopsies were performed. The first was unsuccessful so the Dr. offered to tx her as if it were Langerhans cell histiocytosis which was the only diagnosis that matched her x-ray according to him; low dose chemo/steroids. We opted for a second biopsy which revealed a inactive infection of unknown origin. She is currently on 500 mg bid of Amox-Clav for 6 weeks and is in a brace. After 2 weeks, of antibiotics and about a month in the brace, she is still waking up in the middle of the night with pain that starts out as a tingling radiating pain that wraps around from her back to her chest and then becomes a stabbing pain. She states her level of pain is about an 8. She has a difficulty time breathing at times, and her sternum seems to be protruding even more. We have been dealing with this since late October 2013. I am confused as to why she is receiving antibiotics for an inactive infection and am wondering what this infection could ve been caused by.
Mon, 28 Nov 2016
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Orthopaedic Surgeon 's  Response
Hi
I may suggest bone scan to know if it's osteomyelitis ,a bone infection.Also aspiration culture and sensitivity test for identifying microbe..tubercular bacilli is often a cause...I may advise Mantoux skin test, and other tuberculosis confirmation tests also.anither thing to look for should be sarcoidosis,a fungal infection, which may be ruled out by culture.
You may discuss with your doctor if these could rule out
Intense pain at night means some abscess formation in deep muscles from bone,which can rule out by bone scan
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How To Treat Compression Fracture?

Hi I may suggest bone scan to know if it s osteomyelitis ,a bone infection.Also aspiration culture and sensitivity test for identifying microbe..tubercular bacilli is often a cause...I may advise Mantoux skin test, and other tuberculosis confirmation tests also.anither thing to look for should be sarcoidosis,a fungal infection, which may be ruled out by culture. You may discuss with your doctor if these could rule out Intense pain at night means some abscess formation in deep muscles from bone,which can rule out by bone scan