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Review
. 2019 Jul-Aug;10(4):811-815.
doi: 10.1016/j.jcot.2018.08.005. Epub 2018 Aug 8.

Osteomyelitis variolosa: Forgotten complication of an eradicated disease

Ankit Khurana  1 , Anand Vardhan  1 , Deepak Negi  2
Affiliations
Review

Osteomyelitis variolosa: Forgotten complication of an eradicated disease

Ankit Khurana et al. J Clin Orthop Trauma. 2019 Jul-Aug.

Erratum in

Abstract

Background: Orthopedic manifestations and sequelae of small pox disease are largely forgotten. Presening features in the modern era are not only the classical deformities but also includes precocious arthritis, pathological fractures and joint instability.

Objectives: To conduct a thorough and systematic review of the literature for all articles reporting osteomyelitis variolosa and its sequelae post eradication and to present an additional case as an illustration.

Study design: Systematic review and case report.

Method: ology: PubMed, EMBASE and Google Scholar databases were searched for relevant articles using different combinations of the keywords till 20th June 2017. All articles reporting cases of osteomyelitis variolosa following small pox eradication were included. Pearling of the bibliographies of selected articles was conducted to locate articles missed by the primary database search. Data from these reports were collected on pre-defined forms and the results were analysed.

Results: A total of 8 cases have been reported in the literature so far post-eradication of small pox and all cases are from India. These cases have predominant involvement of elbow followed by hands, feet and ankle. Characteristic clinical signs in the present era are secondary arthritis, pathological fractures, joint instability and some cases even have incidental presentation.The diagnosis is further confirmed by plain radiographs which show pathognomonic features of this condition. Rate of missed/misdiagnosis is very high due to rarity of this condition. All cases in the published literature were managed conservatively except those presenting with pathological fracture.

Conclusions: The purpose of this study is to remind clinicians of an easily recognised sequelae of an eradicated disease and make them aware of its complications.

Keywords: Osteomyelitis variolosa; Small pox.

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Figures

Fig. 1
Fig. 1
PRISMA flowchart showing the study design and the details of inclusion/exclusion of articles.
Fig. 2
Fig. 2
Clinical photographs showing facial stigmata of small pox.
Fig. 3
Fig. 3
Radiographs of the left elbow.
Fig. 4
Fig. 4
Radiographs of the right elbow.
Fig. 5
Fig. 5
Strikingly good function bilaterally despite the deformed and dislocated elbows on radiographs.
See this image and copyright information in PMC

References

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