Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going

to be talking to you about osteomyelitis in children. You can find written notes on this topic

at zero definals.com slash osteomyelitis or in the orthopedic section of the Zero Definals

Pediatrics book. So let's get straight into it.

Osteomyelitis is an infection in the bone and the bone marrow. This typically occurs in the

metaphysis of the long bones. The most common bacteria that causes osteomyelitis is called staphylococcus aureus.

Chronic osteomyelitis is a deep-seated, slow-growing infection with slowly developing symptoms.

Acute osteomyelitis presents more quickly with an acutely unwell child.

The infection may be introduced directly into the bone, for example during an open fracture.

Alternatively, it may have travelled to the bone through the blood after entering the body

through an alternative route such as the skin or the gums.

So what are the risk factors for osteomyelitis?

Osteomyelitis is more common in boys and children under 10 years of age. There is often a risk

factor that predisposes the child to developing osteomyelitis. And this may be an open bone fracture, orthopedic surgery,

they may be immunocompromised, they may have sickle cell anemia, HIV, or coexisting tuberculosis.

And how does osteomyelitis present? Oscemielitis can present acutely with an unwell child

or more chronically with subtle features.

Signs and symptoms are refusing to use the limb or weight bear,

pain, swelling or tenderness.

They may be afebrile or they may have a low-grade fever. Children with acute osteomyelitis may have a high fever,

particularly if it spread to the joint and caused septic arthritis. Let's talk about investigations.

X-rays are often the initial investigation, but they can be normal in osteomyelitis.

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