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Bone & Joint Infections

Bone and joint infections in children are very serious conditions because without correct treatment they can result in impaired growth of bones and permanent joint deformity.Children have a susceptibility to bacterial infection in bones and joints in infancy and early childhood. Premature infants are particularly at risk because their immunity to infection is poorly developed and they require invasive procedures in the setting of a neonatal intensive care unit. However bone and joint infections can occur at any age.

Diagnosis

Osteomyelitis is the medical term for infection in bone. It is nearly always a bacterial infection and the most common causative organism is Staphlococcus aureus (golden staph.). Children who develop acute bacterial osteomyelitis are usually very sick. They are febrile (high temperature) in most cases. They have pain and swelling at the site of the infected bone and cannot use the affected arm or leg normally. Blood tests indicate markedly raised inflammatory markers. Children suspected to have osteomyelitis should be taken to the emergency department of the nearest children’s hospital for treatment.

Septic arthritis is the medical term for infection in a joint. It is nearly always a bacterial infection and the most common causative organism is Staphylococcus aureus (golden staph.). Children who develop septic arthritis are usually very sick. They are febrile (high temperature) in most cases. They have pain and swelling at the site of the infected joint and cannot use the affected arm or leg normally. Blood tests indicate markedly raised inflammatory markers. Children suspected to have septic arthritis should be taken to the emergency department of the nearest children’s hospital for further assessment and treatment.

Treatment

When the diagnosis of osteomyelitis or septic arthritis is made early (within a few days of the onset of symptoms) then the response to treatment is usually excellent. Most cases of osteomyelitis are treated with a prolonged course of antibiotics. The antibiotics are administered intravenously for several days and then orally for several weeks. Septic arthritis may require the surgical drainage of pus from the affected joint and a joint washout (lavage) before the commencement of antibiotic therapy.

Prognosis

In most cases the outcome from the treatment of osteomyelitis and septic arthritis is excellent with no recurrence or long term problems. However bacterial infections which are resistant to standard antibiotics are becoming more prevalent and more difficult to treat. Children who have impaired immunity are more difficult to treat and have a worse prognosis. Also multifocal infections and multi-resistant infections are more difficult to treat and have a worse prognosis.

  • Australian Orthopaedic Association
  • Royal Australasian College of Surgeons
  • The Children's Hospital at Westmead
  • University of New South Wales
  • The University of Sydney logo
  • Australian Paediatric Orthopaedic Society – APOS
  • Sydney Children’s Hospitals Network  - SCHN
  • Australian Medical Association – AMA
  • Ramsay Health
  • The University of Notre Dame