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

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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.

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