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Pediatric musculoskeletal infections
Megan Hannon1,2, Todd Lyons1
1Division of Emergency Medicine.
Insights
Pediatric musculoskeletal infections like septic arthritis and osteomyelitis require prompt diagnosis and targeted treatment. Advances in diagnostics and shorter antibiotic courses improve outcomes, but invasive methods remain crucial for definitive diagnosis.
Area of Science:
- Pediatric infectious diseases
- Musculoskeletal infections
- Rheumatology
Background:
- Common pediatric musculoskeletal infections include septic arthritis, osteomyelitis, pyomyositis, and Lyme disease.
- Recent understanding of causative organisms like Kingella has improved antimicrobial strategies.
Approach:
- Review of recent guidelines and literature on diagnosis and treatment.
- Emphasis on prompt diagnosis and targeted antimicrobial coverage.
- Utilizing advanced diagnostics such as arthrocentesis and MRI.
Key Points:
- Prompt diagnosis and treatment are essential for pediatric osteoarticular infections.
- Rapid lab testing and advanced imaging (MRI, arthrocentesis) are key diagnostic tools.
- Shorter, targeted antibiotic courses with oral transition are effective and reduce complications.
Conclusions:
- Diagnostic and imaging advancements improve pediatric musculoskeletal infection management.
- While progress has been made, invasive techniques are still necessary for definitive diagnosis.
Purpose Of Review:
The aim of this article is to review the recent guidelines and literature regarding the diagnosis and the treatment of common pediatric musculoskeletal infections: septic arthritis, osteomyelitis, pyomyositis, and Lyme disease.
Recent Findings:
In the last decade, a better understanding of the causative organisms of common bacterial infections, including Kingella , leads to prompt targeted antimicrobial coverage in all musculoskeletal infections. Prompt diagnosis and treatment continues to be the mainstay in the treatment of children with osteoarticular infections. Efforts to improve early detection have lead to improving rapid lab diagnostic testing; however, more advanced diagnostics such as arthrocentesis for septic arthritis and MRI for osteomyelitis and pyomyositis, remain the gold standard. Shorter and narrowed antibiotic courses, with appropriate transition to outpatient oral treatment provide effective infection clearance and reduction in complications of disease.
Summary:
Advances in diagnostics, including pathogen identification as well as imaging continues to improve our ability to diagnose and treat these infections, although still lack ability to provide definitive diagnosis without more invasive nor advanced techniques.
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