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World Pediatric Bone And Joint Day: Bone And Joint Infections In Children

| Reviewed By Arya Krishnan

19 October marks the World Pediatric Bone and Joint Day, also knows as World PB & J Day. The day is observed during the Bone and Joint Action Week, which also includes World Arthritis Day, World Spine Day, World Trauma Day and World Osteoporosis Day.

It was initiated by the United States Bone and Joint Initiative in 2012, to improve the prevention of bone and joint disorders, and the quality of life for those affected. The day aims to bring awareness about musculoskeletal conditions of children, and educate healthcare providers and the public about them [1] , also urging the doctors and parents to recognize the effects of obesity in children and take actions - thereby, avoiding the possibilities of lifelong challenges.

The current theme has not been published yet, but the past themes have included obesity, obesity and the growth plate, vitamin D deficiency, the female athlete triad, and ACL injuries. One of the primary focuses of the day is the topic of obesity during childhood, which plays a major role in bone and joint health [2]

Today, we will take a look at the different types of bone and joint problems affecting children.

Bone And Joint Problems In Children

Disorders related to bone and joints in children can be caused by infection, injury or it can be inherited and develop as a part of a child's growth, or occur for no known reason at all. Some bone disorders can cause pain and difficulty, while they do not pose any symptoms [3] .

The most common problem affecting children's bones are infections and then, growing pains (which are harmless and occur during a child's preschool and pre-teen years, and they usually disappear by their teenage years).

A child's bones grow continually and reshape them, where the old bone tissue is gradually replaced by new bone tissue. Most of the disorders affecting the bone of a child changes that occur in a growing child's musculoskeletal system. These disorders may get better or worse as the child grows [4] [5] .

These infections are usually caused by the bacteria, Staphylococcus aureus often termed as Staph. These bacteria can enter your body through various ways and circulate in the bloodstream until reaching a bone or joint tissues [6] .

Types Of Bone And Joint Problems In Children

Septic arthritis (joint infection): infectious arthritis is one of the common infections affecting a child's joints. The infection usually reaches the joints through the bloodstream and is an intensely painful infection and causes redness, heat and pain in a single joint associated with a decreased ability to move the joint. The condition needs immediate medical attention [6] .

The condition is diagnosed through ultrasonography and is treated using a needle aspiration of the affected joint, surgical drainage, and intravenous or oral use of antibiotics.

Osteomyelitis (bone infection): A bacterial infection affecting the bone, osteomyelitis affects the long bones of the arms and legs. It is common can be treated with intravenous or oral use of antibiotics. A rare but serious condition, the infection can reach the bones through various ways like it may spread through the bloodstream into the bone, or an open fracture or surgery may expose the bone to infection [7] .

Post streptococcal reactive arthritis (PSRA): A type of arthritis, PSRA is of acute onset, symmetric or asymmetric and is non-migratory. The condition develops after an upper respiratory infection with streptococcus bacteria. However, the condition can affect any joint and is persistent or recurrent. It causes the joints to swell and is painful [8] .

Symptoms Of Bone And Joint Problems In Children

Children who have problems with their joints and bones will show the following signs and symptoms [9] :

  • Fever
  • Swelling
  • Redness
  • Pain
  • Warmth
  • Limited movement of the infected area
  • Infants may be irritable and lethargic, refuse to eat, or vomit

Diagnosis Of Bone And Joint Problems In Children

The doctors will begin with a physical examination and check the symptoms. The following test will be ordered to gain a clearer understanding of the condition [10] .

  • Needle aspiration
  • Bone scan
  • Blood test
  • Tissue culture
  • Imaging tests such as x-rays, magnetic resonance imaging (MRI) scans, and ultrasound

Treatment For Bone And Joint Problems In Children

Timely diagnosis and treatment help improve the outlook for the child. When infections are not treated early, they can damage tissues and cause chronic problems [11] .

The most common treatment options are mentioned below:

  • Antibiotics
  • Medication to help manage pain and swelling
  • In severe cases, surgery can help clean out the affected areas in and around the bone
View Article References
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  2. [2] Yeşilkaya, E., Bereket, A., Darendeliler, F., Baş, F., Poyrazoğlu, Ş., Aydın, B. K., ... & Sarı, E. (2015). Turner syndrome and associated problems in Turkish children: a multicenter study. Journal of clinical research in pediatric endocrinology, 7(1), 27.
  3. [3] Sohail, H., Ijaz, F., Malik, A., Kamran, R., Javed, S., & Aftab, R. K. (2019). Assessment of insulin like growth factor 1 and bone density in normal and β-thalassemia major children. Pakistan Journal of Physiology, 15(2), 52-55.
  4. [4] Mus-Peters, C. T., Huisstede, B. M., Noten, S., Hitters, M. W., van der Slot, W. M., & van den Berg-Emons, R. J. (2019). Low bone mineral density in ambulatory persons with cerebral palsy? A systematic review. Disability and rehabilitation, 41(20), 2392-2402.
  5. [5] Murugan, S. S., & Srinivasan, V. (2016). Association of bone age with overweight and obesity in children in the age group of 8 to 11 years. International Journal of Contemporary Pediatrics, 3(3), 1.
  6. [6] Popkov, A., Dučić, S., Lazović, M., Lascombes, P., & Popkov, D. (2019). Limb lengthening and deformity correction in children with abnormal bone. Injury, 50, S79-S86.
  7. [7] Finbråten, A. K., Syversen, U., Skranes, J., Andersen, G. L., Stevenson, R. D., & Vik, T. (2015). Bone mineral density and vitamin D status in ambulatory and non-ambulatory children with cerebral palsy. Osteoporosis International, 26(1), 141-150.
  8. [8] Zaragoza, C. A., Garibay, E. M. V., Contreras, A. A. G., Haro, A. L., Velarde, E. R., Rosas, A. R., ... & Olea, I. V. (2018). Bone mineral density and nutritional status in children with quadriplegic cerebral palsy. Archives of osteoporosis, 13(1), 17.
  9. [9] Adamczyk, P., Szczepanska, M., & Pluskiewicz, W. (2018). Skeletal status assessment by quantitative ultrasound and bone densitometry in children with different renal conditions. Osteoporosis International, 29(12), 2667-2675.
  10. [10] Cox, C. L., Zhu, L., Kaste, S. C., Srivastava, K., Barnes, L., Nathan, P. C., ... & Ness, K. K. (2018). Modifying bone mineral density, physical function, and quality of life in children with acute lymphoblastic leukemia. Pediatric blood & cancer, 65(4), e26929.
  11. [11] Sakurai, T., Ishii, N., Takumi, I., Ogawa, R., & Akimoto, M. (2019). Ten-Year Outcomes After Catcher’s Mask Cranioplasty for Large Cranial Bone Defects in Children: A Report of Two Cases. Plastic and Reconstructive Surgery Global Open, 7(8).
Arya KrishnanEmergency Medicine
Arya Krishnan
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