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Study Design.: This was a retrospective multicenter study. Objective.: To develop a novel progression risk stratification scoring system for early-onset scoliosis. Summary of Background Data.: There is a lack of investigations into variables affecting the risk of curve progression in early-onset scoliosis, which prevents stratification. A novel risk score system is needed to help in progression risk estimation. Methods.: A retrospective analysis was done at three centers, from 1995 to 2020. Scoliosis cases before the age of 10 years, were included. Medical identifier, date of birth, sex, primary diagnosis, curve type, date/modality of treatment, date of follow-up appointments, and Cobb angles, were collected. Five ranks were selected for stratification. Categories with the same ranks were discarded. Point scores started at 0, for the lowest risk, and ended at 4, for highest risk. Iterations of variable combinations were conducted and clinical relevance was determined by evaluating sensitivity, specificity, positive predictive value, and negative predictive value based on score ranges for low and high risk of progression. Results.: A total of 476 (230 males, 246 females) early-onset scoliosis patients were collected. The average age at diagnosis was 4.8 years (SD±2.8 yr). The average follow-up duration was 9.3 years (SD±6.9 yr, range: 5 mo–38 yr). Appointments totaled 2911, giving 2182 observations for the analysis. Patient observations numbered: 800 (36.7%) ending in progression, 1265 (58.0%) for nonprogression, 117 (5.4%) for inadequate follow-up, and 368 (16.9%) for rapid progression. The risk scoring system contained four categories: etiology, age, curve magnitude, and curve type. Categorized point combinations totaled 755, giving 1975 iterations. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated to be 85.8%, 96.5%, 89.7%, and 95.1%, respectively. Conclusion.: A novel progression risk score for early-onset scoliosis was derived. The system can reliably differentiate between low and high-risk cases in clinical settings. Further validation in other regions may be important for verifying clinical relevance. Level of Evidence.: Level 3. [ABSTRACT FROM AUTHOR]

Acute osteomyelitis (OM) of the patella is an exceptionally rare condition in children. The rarity of this condition, coupled with its nonspecific symptoms and varied clinical presentations, makes early diagnosis challenging and often results in delayed treatment. Prompt identification and initiation of antibiotic therapy are essential for a full recovery and to prevent the disease from progressing to a chronic, more severe form. This case report discusses a previously healthy six-year-old boy who developed OM of the left patella following a fall from standing height after tripping three days prior to his presentation at the emergency department. Due to the unusual and infrequent nature of patellar OM, it is often overlooked as a potential cause of knee pain in pediatric patients. Clinicians must consider patellar OM in the differential diagnosis for children presenting with knee pain. Accurate and timely diagnosis relies on thorough clinical assessments, laboratory testing, and appropriate imagining techniques (i.e., X-ray and magnetic resonance imaging (MRI)). Early identification and appropriate treatment are critical in preventing the infection from spreading within the joint and ensuring a favorable outcome., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Abdelwahab et al.)