Paediatric bone and joint infections: a guide from diagnosis to management

Paediatric bone and joint infections (PBJI) can be challenging to diagnose due to their non-specific symptoms including fever, pain, swelling, and limited range of motion of the limb. The diagnosis involves a combination of clinical evaluation, laboratory tests, and imaging studies. Plain radiographs, ultrasound, and MRI can aid in the diagnosis of these infections. The approach to treating PBJI is multidisciplinary, involving paediatricians, infectious disease specialists, orthopaedic surgeons, and radiologists. Family-centred care and close follow-up are crucial to ensure optimal outcomes for children with bone infections. Management involves a combination of medical treatment with intravenous and oral antibiotics, and, if required, surgical interventions centred around debriding all dead bone and soft tissue, draining intra- or extra-osseus abscesses, stabilizing pathological fractures and delivering high doses of local antibiotics. Early diagnosis and prompt initiation of appropriate treatment are crucial to prevent long-term complications such as chronic osteomyelitis, septic arthritis, growth disturbances and limb length discrepancies.