Bone and joint infections

Children presenting with a limp pose a diagnostic dilemma for the clinician. Children may present to a number of specialities, hence, confidence in the examination of the joints, and the musculoskeletal system is essential. There should be a high index of clinical suspicion for infection of the bones or joints, in the acute presentation of a child with a painful limp, and particularly, in the non weight-bearing child. This article will discuss the clinical presentations of paediatric bone and joint infections. The approach to clinical assessment, laboratory and radiological investigations, and management of these conditions, will be discussed. Caring for patients with bone and/or joint infections, often involves several specialities; emergency department doctors, general paediatricians, orthopaedic surgeons, radiologists, paediatric rheumatologists, and the paediatric physiotherapy teams. Early and close collaboration between teams will result in prompt investigation and age appropriate care.