Orthopedics Book


Acute Osteomyelitis

Aka: Acute Osteomyelitis, Osteomyelitis in Children, Pediatric Osteomyelitis
  1. See Also
    1. Osteomyelitis
    2. Chronic Osteomyelitis
    3. Pediatric Limp
  2. Epidemiology
    1. More common in boys
  3. Pathophysiology
    1. Inflammatory bone changes associated with pathogenic Bacteria
      1. Staphylococcus aureus is most common cause in Pediatric Osteomyelitis
    2. Typically acute hematogenous spread to Traumatized bone
      1. Most common in children under age 5 (50% of cases)
      2. Most commonly affects the highly vascular metaphyses of long bone
  4. Symptoms
    1. Presentation within two weeks of symptom onset
    2. Fever
    3. Irritability or lethargy
  5. Signs
    1. Systemic signs of infection
    2. Pediatric Limp
    3. Femur, tibia and fibula account for 50% of Osteomyelitis cases in children
    4. Local signs of infection
      1. Tenderness on palpation over involved bone
      2. Localized inflammation with erythema and swelling
      3. Decreased range of motion of adjacent joints
  6. Labs
    1. See Osteomyelitis
    2. ESR and CRP may be early indicators of Osteomyelitis (albeit non-specific)
  7. Imaging
    1. See Osteomyelitis
    2. XRays are often normal for first 2-3 weeks
  8. Diagnosis
    1. See Osteomyelitis
  9. Management
    1. See Osteomyelitis Management
  10. References
    1. Jhun and Raam in Herbert (2016) EM:Rap 16(2):15-6
    2. Hatzenbuehler (2011) Am Fam Physician 84(9): 1027-33 [PubMed]
    3. Boutin (1998) Orthop Clin North Am 29:41-66 [PubMed]
    4. Carek (2001) Am Fam Physician 63(12):2413-20 [PubMed]
    5. Dirschl (1993) Drugs 45:29-43 [PubMed]
    6. Eckman (1995) JAMA 273:712-20 [PubMed]
    7. Haas (1996) Am J Med 101:550-61 [PubMed]
    8. Lew (1997) N Engl J Med 336:999-1007 [PubMed]
    9. Lipsky (1997) Clin Infect Dis 25:1318-26 [PubMed]

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