Recent advances in the evaluation and treatment of pediatric musculoskeletal infection

Recent advances in the evaluation and treatment of children with musculoskeletal infection are focused upon improvements in diagnosis and treatment according to evidence-based clinical practice guidelines. Osteomyelitis, septic arthritis, and pyomyositis demonstrate a wide range of clinical severity, which creates the need for a collaborative multidisciplinary approach to treatment. Important elements in caring for children with these conditions include an organized framework for initial and advanced diagnostic imaging and laboratory evaluation, an efficient method of delivering antibiotic therapy and surgical intervention whenever necessary, and an orientation toward continuity of care to ensure that excellent long-term clinical outcomes are achieved. As we approach an era of cost containment in modern healthcare, clinicians will seek evidence that justifies early transition to oral antibiotic therapy and hospital discharge for these children while continuing to ensure their safety and reduce the risk of readmission because of residual or recurrent infection. The current epidemiology of pediatric musculoskeletal infection is affected by the spectrum of causative organisms that are reported in various communities. Methicillin-sensitive and Methicillin-resistant Staphylococcus aureus remain the most common pathogens responsible for invasive infections but vary substantially as to their relative incidence, depending on the geographical location of the reporting institution.