Bone and Joint infection in Children

1
Bone and Joint infection in Children

• Karen Daly FRCS (Orth)?
• Consultant in Childrens Orthopaedics
• St Georges Hospital

2
Definitions

• Septic arthritis
• Osteomyelitis
• May coexist
• Differing presentations

3
Introduction

• All ages
• Hard to diagnose
• Hard to treat
• Potentially chronic disease
• Devastating effect on growth

4
Neonate

• Fertile bone
• Immature immunity
• Risky environment
• Difficult diagnosis
• Sensitive to antibiotics
• Possible growth arrest

5
Infant

• Minor trauma common
• Common bugs
• Difficult to diagnose
• Usually respond to iv antibiotics
• Possible growth arrest
• Discitis

6
Child

• Rare
• Common bugs
• ?immune compromise
• Surgery may be required
• Possible growth arrest

7
Young adult

• Trauma open fractures
• High energy injury
• Multiple injuries
• Aggressive treatment
• Role of antibiotics limited

8
Special Considerations

• Immune compromise
• Sickle cell disease
• Rheumatoid arthritis
• Unusual organisms

9
Summary

• High index of suspicion
• Aggressive management
• Judicious use of antibiotics
• Appropriate surgical care