Pediatric bone and joint infection treatment

Pediatric bone and joint infection treatment

The treatment and surgery that may be right for your child’s pediatric bone and joint infection depends on a variety of factors, which include age, current and past health, the severity of the infection and history with various medications and treatments. Pediatric bone and joint infections are a result of bacteria in our daily environment that get into the bloodstream and affect the musculoskeletal system.

Diagnosis

A pediatric bone and joint infection can significantly affect your child’s development and quickly spread to other areas of the body. If you think your child might have a bone or joint infection, it is important to seek medical attention quickly to avoid the spread or worsening of this condition. To diagnose the condition, the doctor will start out by asking a series of questions and doing a brief physical exam. To further understand the nature of the condition, the doctor will ask for at least one of these tests:

  • Blood tests – Because these conditions come from bacteria spread by the bloodstream, it is important to test the blood to determine the type of bacteria that may have entered the bone or joint.
  • Tissue culture – Tissue may be taken from the area of the infection to try to gain more information on the specifics of the infection.
  • X-ray (radiograph) – An X-ray gives the doctor an overview of the extent of the damage from the infection, and allows for more sound decisions about which treatment is required.
  • Ultrasound – This test provides the doctor with information on the tissue and fluids in the infected joint and also will help determine the best treatment.  

Nonsurgical treatment

Depending on the type of infection and the age of the child, some pediatric bone and joint infections can be treated with antibiotics. Antibiotics are the most common form of treatment for children aged two to five. The child will need to be watched over time as the antibiotics work to ensure that the infection does not become any worse. Because early detection is so important to the health of the bones and joints, it is important that infections are closely monitored. For this reason, the child may be hospitalized while the antibiotics are being administered and also may receive pain medication to help ease symptoms. 

Surgery

In many cases, pediatric bone and joint infections require surgery to remove the affected skin, bone and tissue. The following are some of the treatments used:

  • Removal of infected tissue – The infected tissue is removed from the joint and bone. If there are significant spaces left where the tissue was removed, a bone graft may be added to encourage regrowth of healthy bone.
  • Needle drainage – The fluid around the site will need to be drained. This requires surgery to ensure all fluid is drained from deep inside the joint area. In many cases, this can be done using a needle aspiration.
  • Arthroscopic drainage – When needle drainage does not work, a scope is put into the joint to help extract the fluids. This is most commonly performed for knee infections.
  • Metaphyseal drainage – For larger joints such as the hip and shoulder, the chances of the infection spreading are greater. Because of this, a larger incision is needed to extract the infected fluid and ensure none is missed.

The multidisciplinary team of pediatric bone and joint experts at Northwell Health Orthopaedic Institute performs pediatric bone and joint infections surgery as well as a broad range of nonsurgical and surgical treatments for conditions that affect the bones.

Research

Most of the research on pediatric bone and joint infections has to do with managing and treating the infection properly so that it does not return and so that there are no complications. In many communities, the emergence of methicillin-resistant staphylococcus aureus (MRSA) has been seen. This specific type of infection does not respond to most antibiotics and has been linked to serious illness and even death in children. Minor cases that are caught early can be managed effectively through antibiotics. More research is being done to determine the best approach to handle multifocal infections in children.

In communities where MRSA is prevalent, other treatment methods are being researched to try to determine how to respond to this specific type of bacteria. Infection rates have increased to as high as 60 percent in emergency rooms, making the need to control this penicillin-resistant infection even greater. Some forms of antibiotics, such as linezolid, have been used to treat MRSA. However, when it comes to the delicate cases of pediatric bone and joint infections, there is still a lot of work to be done to properly treat these diseases without creating a negative reaction in children’s growing bodies.

As research on pediatric bone and joint infections is ongoing, it is a good idea for your conversation about it with your doctor to be ongoing as well.

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