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

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.