Clinical manifestations and outcomes of children with bone and joint infections
Öz
Purpose: This study aimed to determine the clinical, laboratory, imaging, and bacteriological features of bone and joint infections in children and to identify their characteristic features for early diagnosis.
Materials and Methods: In this retrospective study patients diagnosed with osteomyelitis and septic arthritis, based on established guidelines, were included. We collected demographic, clinical, and imaging data, along with inflammatory markers and microbiological data, and any invasive procedures performed by orthopedic surgeons. We also reviewed the development of long-term sequelae, the duration of treatments, and the types of antibiotics used for both oral and parenteral therapy.
Results: The study group consisted of 25 patients with osteomyelitis, 10 with septic arthritis, and 5 with combined infection (osteomyelitis and septic arthritis). Inflammatory marker levels were abnormal in most children. The most commonly identified organism was the Staphylococcal species. Radiological findings compatible with bone and joint infections were detected in all patients whose magnetic resonance imaging results were available. Invasive procedures were performed in 44%, 90%, and 100% of the patients with osteomyelitis, septic arthritis, and combined infection, respectively.
Conclusion: Sensitivity increased when all the markers were used together. Magnetic resonance imaging considered the most informative imaging modality for bone and joint infections provided the highest sensitivity in our study. These sensitive indicators can be helpful for the early diagnosis and long-term follow-up of patients with unclear presentations.
Anahtar Kelimeler
Kaynakça
- Nadau E, Joseph C, Haraux E, Deroussen F, Gouron R, Klein C. Clinical features and outcomes in children with bone and joint infections of the ankle or foot. Arch Pediatr.2020;27:464-8.
- Akinkugbe O, Stewart C, McKenna C. Presentation and investigation of pediatric bone and joint infections in the pediatric emergency department. Pediatr Emerg Care. 2019;35:700-4.
- Spyridakis E, Gerber JS, Schriver E, Grundmeier RW, Porsch EA, St Geme JW et al. Clinical features and outcomes of children with culture-negative septic arthritis. J Pediatric Infect Dis Soc.2019;8:228-34.
- Belthur MV, Palazzi DL, Miller JA, Phillips WA, Weinberg J. A clinical analysis of shoulder and hip joint infections in children. J Pediatr Orthop. 2009;29:828-33.
- Woods CR, Bradley JS, Chatterjee A, Copley LA, Robinson J, Kronman MP et al. Clinical practice guideline by the pediatric infectious diseases society and the infectious diseases society of America: 2021 Guideline on diagnosis and management of acute hematogenous osteomyelitis in pediatrics. J Pediatric Infect Dis Soc. 2021;10:801-44.
- Dartnell J, Ramachandran M, Katchburian M. Haematogenous acute and subacute paediatric osteomyelitis: a systematic review of the literature. J Bone Joint Surg Br. 2012;94:584-95.
- Manz N, Krieg AH, Heininger U, Ritz N. Evaluation of the current use of imaging modalities and pathogen detection in children with acute osteomyelitis and septic arthritis. Eur J Pediatr. 2018;177:1071-80.
- Abeywickrema M, Liu X, Kelly DF, Theologis T, Pollard AJ, Kadambari S. Bone and joint infections in Oxford: a 10-year retrospective review. Arch Dis Child. 2020;105:515-6.
- Levine MJ, McGuire KJ, McGowan KL, Flynn JM. Assessment of the test characteristics of c-reactive protein for septic arthritis in children. J Pediatr Orthop. 2003;23:373-7.
- Mediamolle N, Mallet C, Aupiais C, Doit C, Ntika S, Vialle R et al. Bone and joint infections in infants under three months of age. Acta Paediatr. 2019;108:933-9.
