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Paediatric bone and joint infection.

Alexios D Iliadis1, Manoj Ramachandran1

  • 1Centre for Orthopaedics, The Royal London and Barts and The London Children's Hospitals, Barts Health NHS Trust, London, UK.

EFORT Open Reviews
|June 14, 2017
PubMed
Summary
This summary is machine-generated.

Diagnosing paediatric osteoarticular infections requires combining clinical signs, imaging, and labs, as no single test is definitive. Shorter antibiotic courses and early oral conversion appear safe and effective for bone and joint infections.

Keywords:
osteomyelitispaediatricseptic arthritis

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Area of Science:

  • Orthopedics
  • Pediatric Infectious Diseases
  • Clinical Microbiology

Background:

  • Paediatric osteoarticular infections present diagnostic challenges, with diagnostic delays leading to significant morbidity.
  • Current diagnostic methods, including joint aspiration, lack sufficient reliability for conclusive diagnosis.
  • Optimal surgical and antibiotic treatment strategies remain incompletely defined.

Purpose of the Study:

  • To review current understanding and management of paediatric osteoarticular infections.
  • To highlight diagnostic difficulties and the need for a multimodal diagnostic approach.
  • To discuss evolving treatment paradigms, including antibiotic therapy and surgical roles.

Main Methods:

  • Comprehensive literature review of paediatric osteoarticular infections.
  • Analysis of diagnostic modalities: clinical assessment, imaging, laboratory tests, and joint aspiration.
  • Evaluation of treatment strategies: antibiotic duration/route, surgical interventions, and emerging pathogens.

Main Results:

  • Diagnosis relies on a combination of clinical, imaging, and laboratory findings; algorithms should support, not replace, clinical judgment.
  • Limited role for surgery in acute haematogenous osteomyelitis; roles in septic arthritis require further definition.
  • Shorter antibiotic courses (3 weeks) and early oral switch (day 4) show promise; *Kingella kingae* and resistant *Staphylococcus aureus* strains are increasingly prevalent.

Conclusions:

  • An integrated, evidence-based, multidisciplinary approach is essential for optimal outcomes in paediatric osteoarticular infections.
  • Further large-scale studies are needed to establish definitive management guidelines.
  • Accurate diagnosis and timely, appropriate treatment are critical to minimize morbidity.