Infections of the bones and joints are often seen in children. They commonly follow septicaemia although occasionally may result from a penetrating injury. In children with sickle cell disease, more than one bone may be affected.
Clinical Features
The affected child looks sick and may be toxic. There is fever and limitations of movement of the affected limb. The affected limb is hot and extremely tender. The child may resist examination because of pain. Delay in treatment will result in bone or joint destruction. In the case of osteomyelitis, a chronic discharging sinus may develop.
Investigation
Full blood count
Blood culture
X-ray of affected limb
Joint aspirate for culture and sensitivity
Management
Admit
Give analgesics.
Start antibiotic, penicillin and gentamicin, duration 4-6 weeks.
Place limb in position of comfort.
Refer to surgeon if:
Need to aspirate under anaesthesia.
Chronic osteomyelitis if need to remove dead bone (sequestrum).