Bone, Joint, and Muscle Infections in Children

Septic arthritis (joint infection): Infectious, or septic, arthritis is an infection in one of your child’s joints. The infection usually reaches the joints through the bloodstream.  Treating the joint infection promptly is important to prevent it from becoming a chronic, or long-term, disorder.  Treatment can include a needle aspiration of the hip joint, surgical drainage, and intravenous (IV) or oral use of antibiotics.

Pyomyositis (muscle infection)

Pyomyositis (muscle infection):  Pyomyositis is a bacterial Infection of  the skeletal muscles.  A child with pyomyositis  will be referred to an orthopedist (doctor specializing in treating bone and joint problems) for evaluation and treatment. Treatment can include surgical drainage, and intravenous (IV) or oral use of antibiotics.

Post streptococcal reactive arthritis (PSRA)

Post streptococcal reactive arthritis (PSRA) *: Arthritis of acute onset, symmetric or asymmetric, usually non-migratory, which can affect any joint and is persistent or recurrent. A child with PSRA  will be referred to a Rheumatologist (A specialist in the non-surgical treatment of rheumatic illnesses, especially arthritis) for evaluation and treatment.

Children who have infections of their bones, joints or muscles often have the following:

• Fever
• Pain
• Swelling
• Redness
• Limited movement of the infected area — your child may limp or refuse to walk if the infection involves the legs or back
• Infants may be irritable and lethargic, refuse to eat, or vomit
• Warmth

Many children who have bone, joint, or muscle infections have had recent injuries. The symptoms of infection are often masked by those of the injury. Because parents assume the injury will get better over time, it may take them longer to notice the infection.

It is important to bring your child to a doctor immediately if symptoms are not quickly resolving at home.

Our doctors can look for signs of infection with a careful physical examination and by asking questions about symptoms. The key to successful treatment of bone infections and septic arthritis is prompt attention.

Tests that may help confirm a diagnosis and plan your child's treatment include:

• Bone scans: Uses a small amount of radioactive substance to make detailed images of the bones
• Needle aspiration: Removes a sample from the bone to identify the bacteria causing the infection
• Blood tests and tissue cultures: Tests on your child's blood, as well as fluid and /or tissue from the infected area, can help identify the bacteria or other organism causing the infection. This information about the infection helps your doctor determine the most effective ways to treat it.
• Imaging tests: Tests such as x-rays, magnetic resonance imaging (MRI) scans, and ultrasound, provide your child's doctor with pictures of the bones, muscles, and soft tissues in the affected area. Your doctor will look for swelling around bones and muscles, or fluid within the joints that are infected. This information helps your doctor when making the decision to treat the infection with antibiotics alone, or to perform surgery to help resolve it.

Prompt diagnosis and treatment of all infectious disorders involving bone, joint, or muscle helps improve the outlook for your child. When infections are not treated early, they can damage tissues and cause chronic problems.

At Children’s Health, we provide comprehensive care for a range of orthopedic disorders using a multidisciplinary approach that addresses all your child’s needs, from diagnosis through treatment and recovery. Our pediatric orthopedic physicians will create a personalized treatment plan for your child.

Treatment options include:

• Medication to help manage pain and swelling
• Antibiotics
• In serious cases, surgery to clean out the affected areas in and around the bone