Musculoskeletal infections in adolescents.

Musculoskeletal infections are uncommon disorders in adolescents and represent unique diagnostic and therapeutic challenges to the clinician. The pathogenesis, treatment, and prognosis of many musculoskeletal infections vary markedly in children compared to adults based in part on behavioral differences, bone growth, and changing vascularity patterns. Since adolescents can exhibit manifestations of infection common to either age range, a familiarity with the differences is essential for successful management. This article reviews common musculoskeletal infections affecting normal adolescent population, but also includes special considerations. Hematogenous osteomyelitis and suppurative arthritis are reviewed in detail, including pathogenesis, etiology, signs and symptoms, diagnosis, laboratory tests, radiologic imaging, and treatment. Also discussed are contiguous osteomyelitis with and without vascular insufficiency, puncture wound osteomyelitis, vertebral osteomyelitis, osteomyelitis with sickle cell disease, chronic osteomyelitis, pyomyositis, acute bacterial myositis, and nonstreptococcal myonecrosis.