The management of septic arthritis in children

Author:

Kang S.-N.1,Sanghera T.2,Mangwani J.1,Paterson J. M. H.1,Ramachandran M.1

Affiliation:

1. Department of Trauma and Orthopaedics, The Royal London Hospitals, Barts and The London NHS Trust, Whitechapel Road, Whitechapel, London E1 1BB, UK.

2. University of Nottingham Medical School, Queen’s Medical Centre, Nottingham NG7 2UH, UK.

Abstract

We performed a systematic review of the optimal management of septic arthritis in children as recommended in the current English literature using MEDLINE, EMBASE, CINAHL, the Cochrane Library and reference lists of retrieved articles without date restrictions up to 31 January 2009. From 2236 citations, 227 relevant full-text articles were screened in detail; 154 papers fulfilled the inclusion criteria, from which conclusions were drawn on the management of infected joints in children. Our review showed that no single investigation, including joint aspiration, is sufficiently reliable to diagnose conclusively joint infection. The roles of aspiration, arthrotomy and arthroscopy in treatment are not clear cut, and the ideal duration of antibiotic therapy is not yet fully defined. These issues are discussed. Further large-scale, multi-centre studies are needed to delineate the optimal management of paediatric septic arthritis.

Publisher

British Editorial Society of Bone & Joint Surgery

Subject

Orthopedics and Sports Medicine,Surgery

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