Pediatric Osteomyelitis

Updated: May 02, 2016
  • Author: Sabah Kalyoussef, DO; Chief Editor: Russell W Steele, MD  more...
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Overview

Background

Osteomyelitis, or inflammation of the bone, is usually caused by bacterial infection. Bone infections in children are primarily hematogenous in origin, although cases secondary to penetrating trauma, surgery, or infection in a contiguous site are also reported.

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Pathophysiology

Approximately 50% of cases occur in preschool-aged children. Young children primarily experience acute hematogenous osteomyelitis due to the rich vascular supply in their growing bones. Circulating organisms tend to start the infection in the metaphyseal ends of the long bones because of the sluggish circulation in the metaphyseal capillary loops. The presence of vascular connections between the metaphysis and the epiphysis make infants particularly prone to arthritis of the adjacent joint. Involvement of the shoulder joint or hip joint is also noted when the intracapsular metaphyseal end of the humerus or femoral is infected. If untreated, infection can also spread to the subperiosteal space after traversing the cortex.

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Epidemiology

Frequency

United States

The exact frequency is unknown as osteomyelitis is not a reportable disease.

International

Chronic osteomyelitis is frequently reported in developing countries where medical and surgical treatment modalities are not commonly accessible.

Mortality/Morbidity

As noted in recent studies, patients may develop deep vein thrombosis and fractures. [1, 2, 3, 4]

Race

Few studies have commented on race differences.

Sex

A preponderance in males is observed in all age groups. Factors related to increased incidence in males may include increased trauma due to risk-taking behavior or other physical activities that predispose to bone injury.

Age

One half of cases occur in preschool-aged children.

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