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Concurrent septic arthritis and osteomyelitis in children

Corey O Montgomery1, Eric Siegel, Robert D Blasier

  • 1Department of Orthopaedics, Center for Orthopaedic Research, University of Arkansas Medical Sciences, Little Rock, AR 72205, USA. comontgomery@uams.edu

Journal of Pediatric Orthopedics
|May 9, 2013
PubMed

Insights

Concurrent infections (CI) of septic arthritis and osteomyelitis are common in newborns and adolescents, particularly in the shoulder. Early diagnosis using advanced imaging can reduce hospital stays and surgical procedures.

Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Radiology

Background:

  • Septic arthritis and osteomyelitis are serious conditions that can occur together.
  • Delayed diagnosis of concurrent infections (CI) can lead to worse outcomes.

Purpose of the Study:

  • To identify factors aiding earlier diagnosis of concurrent infections (CI) in patients with septic arthritis.

Main Methods:

  • Retrospective chart review of 200 patients with septic arthritis.
  • Comparison of patients with CI versus septic arthritis alone using statistical tests.

Main Results:

  • 21.5% of patients had CI.
  • CI were most prevalent in newborns and adolescents (P<0.0001) and shoulder infections (72%, P<0.0001).
  • CI correlated with longer symptom duration (median 6 days), longer hospital stays (median 6 days), more operations, and higher ICU admission rates.

Conclusions:

  • Advanced imaging (CT, bone scan, MRI) is recommended for patients with septic arthritis who are neonates, adolescents (13-20 years), have shoulder involvement, or symptoms >6 days.
  • Early identification of CI can potentially reduce hospital stays, operative procedures, and infection-related complications.
Abstract

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