Bone infarction versus infection in sickle cell disease in children

We reviewed emergency admissions for the complaint of musculoskeletal symptoms for 113 children with sickle cell disease. Over a 2-year period, we accumulated a total of 247 admissions to a major children's hospital. Four osteoarticular infections were identified, resulting in an incidence of 1.6% per admission for musculoskeletal complaints. Admission history, physical findings, laboratory values, and radiographic studies were reviewed. We compared findings in the group with the positive diagnosis of osteoarticular infections with those who were thought to have only vaso-occlusive crisis. Although three of the four patients with infection had plain roentgenogram changes at the time of diagnosis, no statistically significant differences in the two groups could be determined.