The Beit CURE Classification of Childhood Chronic Haematogenous Osteomyelitis-a guide to treatment

Background: The Beit CURE (BC) classification is a radiographic classification used in childhood chronic haematogenous osteomyelitis. The aim of this study is to assess correlation between this classification and the type and extent of treatment required. Methods: We present a retrospective series of 145 cases of childhood chronic haematogenous osteomyelitis classified using the BC classification. Variables measured include age, sex, bone involved, number of admissions, length of stay, type/number of operations and microbiology. Results: The most commonly affected bone was the tibia (46 %), followed by femur (26 %) and humerus (10 %). Bone defects were most common in the tibia. Staphylococcus aureus was the most commonly isolated organism. Type B, sequestrum type, was the most common (88 %), followed by type C, sclerotic type, (7 %) and type A, Brodie's abscess (5 %). Types A and B1 had the shortest length of hospitalisation (11 days), type B4 had the longest (87 days). Types A and B1 had the fewest infection control operations. Type B4 had the greatest total number of operations. Conclusions: This study shows that the BC classification can guide surgical strategy and help predict length of inpatient treatment and number and type of procedures required.