Am Fam Physician. 2024;110(6):650-653
Author disclosure: No relevant financial relationships.
KEY POINTS FOR PRACTICE
• Initial evaluation of suspected acute bacterial arthritis in children should include blood cultures before antimicrobial treatment, plain radiography, and consideration of a CRP level for monitoring treatment response without serum procalcitonin level or erythrocyte sedimentation rate.
• Although joint aspiration is recommended, it may be more important to determine the presence of associated osteomyelitis because more than one-third of these patients experience complications.
• For iIl-appearing children, antibiotic treatment should not be delayed for joint aspiration.
• Initial antibiotic treatment duration of 10 to 14 days is recommended for common pathogens.
From the AFP Editors
Acute bacterial arthritis affects up to 1 in 10,000 children annually. It most often is the result of hematogenous spread to a synovial joint such as the knee, ankle, elbow, or shoulder. The hip is the most commonly infected, in up to 40% of cases. The knee, ankle, elbow, and shoulder also are commonly infected. Bacterial infection of fibrocartilaginous joints without synovial fluid, such as intervertebral joints, the pubic symphysis, and sacroiliac joints, is rare and difficult to diagnose.
Subscribe
From $165- Immediate, unlimited access to all AFP content
- More than 130 CME credits/year
- AAFP app access
- Print delivery available
Issue Access
$59.95- Immediate, unlimited access to this issue's content
- CME credits
- AAFP app access
- Print delivery available
