Fig. 2

A, B A 2-year-old boy presented with high fever, swelling, and tenderness of the left lower leg. The inflammatory indexes on admission were all elevated. Computed tomography revealed soft tissue swelling of the left lower leg but no fracture or bone destruction. An MRI examination revealed abnormal signals in the proximal tibia soft tissue and bone marrow cavity (C, D). The treatment administered was an antibiotic combination with tibial cortex fenestration, lesion removal, VAC negative pressure drainage; postoperative pathological findings suggested suppurative osteomyelitis. Bacterial culture suggested MRSA, following which the antibiotic was replaced with vancomycin. The VAC negative pressure was removed after four rounds of surgical treatment, and the total duration of hospital stay was 60 days. The inflammatory indicators and body temperature were normal at discharge, and the re-examination radiograph indicated bone destruction at the proximal tibia (E, F). Nine months after surgery, radiographs indicated remodeling of the proximal tibia (G), with normal lower limb function and no postoperative complications