SEPTIC ARTHRITIS AND OSTEOMYELITIS IN CHILDREN

Infections of the bone or joints are often seen in children. They commonly follow septicaemia although occasionally may result from a penetrating injury. In children with sickle cell disease, more than one bone may be affected.

Clinical Features

  • The affected child looks sick and may be toxic.
  • There is fever
  • Limitation of movement of the affected limb.
  • The affected limb is hot and extremely tender.
  • The child may resist examination because of pain.Delay in treatment will result in bone or joint destruction. In the case of osteomyelitis a chronic discharging sinus
    may develop.

Investigation

  • Full blood count
  • Blood culture
  • X-ray of affected limb
  • Joint aspirate for culture and sensitivity

Management

  • Admit.
  • Give analgesics.
  • Start antibiotic, penicillin and gentamicin, duration 4–6 weeks.
  • Place limb in position of comfort.
  • Refer to surgeon if
    • Need to aspirate under anaesthesia.
    • Chronic osteomyelitis if need to remove dead bone (sequestrum).