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Comprehensive Analysis of the Spectrum of Osteoarticular Infections in Children

Zaid Alhinai1, Hassan El Chebib2,3, Lawrence Huang4

  • 1Department of Child Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.

Journal of the Pediatric Infectious Diseases Society
|January 27, 2025
PubMed

Insights

Subacute, chronic, and non-hematogenous pediatric osteoarticular infections (OAIs) are common and cause significant long-term issues. Understanding these less-studied OAI types is crucial for better patient outcomes.

Area of Science:

  • Pediatric infectious diseases
  • Orthopedic surgery
  • Rheumatology

Background:

  • Existing research on pediatric osteoarticular infections (OAIs) primarily addresses acute hematogenous osteomyelitis (AHO) and acute bacterial arthritis (ABA).
  • A comprehensive analysis of all pediatric OAI types, including subacute, chronic, and non-hematogenous forms, is currently lacking.

Purpose of the Study:

  • To conduct a comprehensive descriptive analysis of all pediatric osteoarticular infections (OAIs).
  • To compare the clinical, radiological, and laboratory characteristics of different OAI classifications.
  • To identify factors contributing to chronic morbidity in pediatric OAIs.

Main Methods:

  • A retrospective analysis of 582 pediatric OAI cases from two academic centers.
  • Infections were categorized into AHO, ABA, subacute or chronic hematogenous osteomyelitis (SCHO), non-hematogenous osteoarticular infection (NHI), and hardware-associated osteoarticular infection (HOI).
  • Comparison of clinical, radiological, and laboratory data across infection types.

Main Results:

  • AHO and ABA presented more acutely with higher fever and inflammatory markers.
  • Subacute, chronic, and non-hematogenous OAIs (SCHO, NHI, HOI) were more prevalent in older children and adolescents.
  • Staphylococcus aureus was the most common pathogen; polymicrobial infections were noted in NHI and HOI.
  • Chronic morbidity occurred in 15% of patients, predominantly in SCHO, NHI, and HOI groups.

Conclusions:

  • Subacute, chronic, and non-hematogenous osteoarticular infections (SCHO, NHI, HOI) represent a substantial portion of pediatric OAIs.
  • These less-common OAI types are disproportionately associated with chronic morbidity in children.
  • Further research into the management and long-term outcomes of SCHO, NHI, and HOI is warranted.
Abstract

Keywords:
acute bacterial arthritischildrenhardware-associated infectionosteoarticular infectionsosteomyelitis

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