Review examines tools for diagnosing pediatric musculoskeletal infections

This review summarizes evidence on blood biomarkers (WBC, ANC, ESR, CRP, procalcitonin) and clinical prediction tools used to evaluate suspected bacterial musculoskeletal infections, such as septic arthritis, osteomyelitis, and pyomyositis, in children presenting to the emergency department. The authors state that individual biomarkers have limited diagnostic accuracy alone, and discuss how combining lab values with clinical features via prediction tools may help clinicians balance the risks of missed infection against unnecessary invasive testing, imaging, sedation, hospitalization, and antimicrobial treatment. The review offers a framework intended to help identify which children require advanced testing versus those who may be low risk.

Most relevant for: Children presenting to the emergency department with suspected bacterial musculoskeletal infection where the differential includes transient synovitis, Lyme arthritis, reactive arthritis, or other inflammatory arthritides.

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Informational only. Not medical advice. Not a substitute for clinical judgment. Always consult current guidelines and your own clinical judgment.