In infancy, bone and joint infections in children, such as septic arthritis, are frequently observed, with the hip joint being commonly affected. The primary culprits are often staphylococcus, streptococcus, and pneumococcus bacteria, with umbilical sepsis being a common source of infection. Early detection is crucial, as symptoms like poor feeding, absence of high temperature, and limb immobility, referred to as “pseudoparalysis,” may manifest within a week or ten days after birth. Timely diagnosis, facilitated by imaging tools like X-rays, MRI scans, and, if needed, bone scans, is vital to prevent permanent disability caused by the potential destruction of the femur’s head cartilage.
oint Infections: Preventing Permanent Damage
Early antibiotic therapy, letting out the pus by arthrotomy (opening the joint by surgery) and immobilization will save the joint. If not attended immediately, permanent structural changes will occur in the bones of the hip joint leading on to gross shortening of the affected limb and limitation of movements of the hip joint.
Osteomyelitis is inflammation of the bone caused by bacteria. These bacteria may come from tonsillitis, abscess in some part of the body, and respiratory infection and gets into the blood stream and settle down in the bone and that is why it is called as acute hematogenous Osteomyelitis. In children above 18months, there may be a history of mild trauma, followed by temperature. On many occasions, the pain in the leg or thigh is attributed to the trauma and the infection is missed in the bone. The commonest bones that are affected are the lower end of the femur (Thigh bone) and the upper end of the tibia (Leg bone). But it can occur in any bone in the body.
The bacteria gets settled in the metaphysis of a long bone and starts multiplying and form an abscess which is within the bone. This will cause severe pain, high temperature and child will be limping. This stage is invariably missed by parents and treating physician as post-traumatic blood collection in the affected area. Later on, the abscess inside the bone spreads to the periphery and center of bone and the abscess comes to the surface of the skin.
By this time enough damage is done to the blood supply of bone leading on to chronic Osteomyelitis which is a very difficult problem to deal with. Hence children with acute hematogenous Osteomyelitis must be diagnosed early with proper diagnosis.
In cases of bone and joint infections in children, early detection is critical, as X-ray appearances may appear normal in the acute stage, potentially leading to oversight. Increased total white cell count and findings on MRI or bone scan can aid diagnosis. Rapid initiation of intravenous broad-spectrum antibiotics and limb immobilization are crucial. Persistent pain and temperature may necessitate surgical intervention, including pus drainage and culture testing, to prevent the progression to chronic Osteomyelitis. Vigilant management is key to averting the complications of bone and joint infections in children
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