Clinical manifestations and outcomes of children with bone and joint infections

Abstract

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.