The PIC Bone Study

• Research type

  Research Study

• Full title

  Imaging in Paediatric Osteomyelitis (the PIC Bone study): a multi-centre cohort study to understand the role of Magnetic Resonance Imaging (MRI) and Ultrasound (USS) in the diagnosis of acute haematogenous osteomyelitis in children.

• IRAS ID

  318114

• Contact name

  Tim Theologis

• Contact email

  tim.theologis@msd.ox.ac.uk

• Sponsor organisation

  Research Governance, Ethics and Assurance Team

• Duration of Study in the UK

  1 years, 10 months, 29 days

• Research summary

  Background:

  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.

  Aims:
  1. To understand how helpful ‘special tests’ (i.e. ultrasound and MRI scans) are in diagnosing bone and joint infections in children.

  2. To create a pathway that doctors and nurses can use in emergency departments to aid the diagnosis of bone and joint infections.

• REC name

  West Midlands - Solihull Research Ethics Committee

• REC reference

  23/WM/0027

• Date of REC Opinion

  21 Mar 2023

• REC opinion

  Further Information Favourable Opinion