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Slovenska pediatrija 2019; 26: 174-181


Review article

URGENT AND MOST COMMON CONDITIONS OF THE MUSCULOSKELETAL SYSTEM - A PAEDIATRIC INFECTIOUS DISEASES SPECIALIST’S VIEW

Nika Morgan
Oddelek za pediatrijo Splošna bolnišnica Izola Polje 40, 6310 Izola, Slovenija

Petra Prunk
Klinika za infekcijske bolezni in vročinska stanja, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

Marko Pokorn
Klinika za infekcijske bolezni in vročinska stanja, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija Pediatrična klinika Ljubljana, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija Katedra za infekcijske bolezni in epidemiologijo, Medicinska fakulteta, Univerza v Ljubljani, Ljubljana, Slovenija

Abstract

In a child with fever, limping, refusal to use an extremity or experiencing limb pain, musculoskeletal infection should always be considered. Two frequent and important clini­cal conditions are septic arthritis and osteomyelitis. In more rare cases, the cause can be a muscle infection, pyogenic myositis, or infection of the fasciae (necrotizing fasciitis). All these clinical conditions can, in case of inadequate or delayed treatment, result in lifelong sequelae and, if left untreated, can even progress to sepsis, shock and death. Viral pathogens or the Borrelia burgdorferi spirochete can also be a cause of arthritis, but in the latter, the course of the disease is usually less acute and slower. In the article, we present two of the most common pae­diatric infections of the musculoskeletal system -septic arthritis and osteomyelitis of the limbs. when an osteoar­ticular infection is suspected in children, a team approach of the primary care paediatrician, paediatric infectious dis­eases specialist, skeletal radiologist, clinical microbiologist and orthopaedic surgeon is necessary. Diagnosis should be made as soon as possible, followed by appropriate antibiotic treatment. Sometimes, a surgical procedure is needed. The prognosis of osteoarticular infections in children, if treated on time and adequately, is usually good. we also present two algorithms on management of septic arthritis and osteomyelitis in children.

Key words: septic arthritis, osteomyelitis, Staphylococcus aureus, Kingella kingae


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