Evidence-Based Treatment for Musculoskeletal Infection

Musculoskeletal infection (MSKI) in children is a common cause of hospitalization in the pediatric population worldwide. Severity of disease is dependent upon the amount and type of tissue involved. Though common, pediatric MSKI diagnosis and treatment can be challenging. In this chapter, we have critically reviewed and summarized the evidence that underpin the current practice in the developed world. Evidence-based treatment guidelines applied by a multidisciplinary team resulted in better care of children with MSKI (Grade B). Non-contrasted MRI is the diagnostic modality of choice to distinguish isolated septic arthritis from adjacent infection (Grade B). Septic arthritis is the most common diagnosis with synovial fluid WBC counts between 25,000 and 75,000 cells/mm3 and can be adequately treated by both arthroscopy or traditional arthrotomy (Grade B). Acute haematogenous osteomyelitis (AHO) can be treated with short course of IV antibiotic, followed by oral antibiotic for 3–4 weeks (Grade B).