The limping child: an algorithm to outrule musculoskeletal sepsis.

Hdl Handle:
http://hdl.handle.net/10147/209273
Title:
The limping child: an algorithm to outrule musculoskeletal sepsis.
Authors:
Delaney, R A; Lenehan, B; O'sullivan, L; McGuinness, A J; Street, J T
Affiliation:
Department of Trauma and Orthopaedics, Cork University Hospital, Cork, Ireland., Delaney.ruth@gmail.com
Citation:
Ir J Med Sci. 2007 Sep;176(3):181-7. Epub 2007 Jul 12.
Journal:
Irish journal of medical science
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/209273
DOI:
10.1007/s11845-007-0061-7
PubMed ID:
17624502
Abstract:
BACKGROUND: The acutely limping child presents a significant diagnostic challenge. AIM: The purpose of this study was to create a clinically useful algorithm to allow exclusion of 'musculoskeletal sepsis' as a differential diagnosis in the child presenting with limp. METHODS: Data were collected on all 286 limping children admitted to our centre over a 3-year-period. Using logistic regression analysis, the predictive model was constructed, to exclude infection. RESULTS: Duration of symptoms, constitutional symptoms, temperature, white cell count and ESR were significantly different in children with musculoskeletal infection (P < 0.05). Multivariate analysis demonstrated that when all three variables of duration of symptoms >1, <5 days; temperature >37.0 degrees C; and ESR >35 mm/h were present, the predicted probability of infection was 0.66, falling to 0.01 when none were present. CONCLUSION: This multivariate model enables us to rule out musculoskeletal infection with 99% certainty in limping children with none of these three presenting variables.
Language:
eng
MeSH:
Algorithms; Arthritis, Infectious/diagnosis; Bone Diseases, Infectious/*diagnosis; C-Reactive Protein/analysis; Child; Child, Preschool; Female; *Gait; Humans; Infant; Male; Multivariate Analysis; Muscular Diseases/*diagnosis; Osteomyelitis/diagnosis
ISSN:
1863-4362 (Electronic); 0021-1265 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorDelaney, R Aen_GB
dc.contributor.authorLenehan, Ben_GB
dc.contributor.authorO'sullivan, Len_GB
dc.contributor.authorMcGuinness, A Jen_GB
dc.contributor.authorStreet, J Ten_GB
dc.date.accessioned2012-02-03T15:16:51Z-
dc.date.available2012-02-03T15:16:51Z-
dc.date.issued2012-02-03T15:16:51Z-
dc.identifier.citationIr J Med Sci. 2007 Sep;176(3):181-7. Epub 2007 Jul 12.en_GB
dc.identifier.issn1863-4362 (Electronic)en_GB
dc.identifier.issn0021-1265 (Linking)en_GB
dc.identifier.pmid17624502en_GB
dc.identifier.doi10.1007/s11845-007-0061-7en_GB
dc.identifier.urihttp://hdl.handle.net/10147/209273-
dc.description.abstractBACKGROUND: The acutely limping child presents a significant diagnostic challenge. AIM: The purpose of this study was to create a clinically useful algorithm to allow exclusion of 'musculoskeletal sepsis' as a differential diagnosis in the child presenting with limp. METHODS: Data were collected on all 286 limping children admitted to our centre over a 3-year-period. Using logistic regression analysis, the predictive model was constructed, to exclude infection. RESULTS: Duration of symptoms, constitutional symptoms, temperature, white cell count and ESR were significantly different in children with musculoskeletal infection (P < 0.05). Multivariate analysis demonstrated that when all three variables of duration of symptoms >1, <5 days; temperature >37.0 degrees C; and ESR >35 mm/h were present, the predicted probability of infection was 0.66, falling to 0.01 when none were present. CONCLUSION: This multivariate model enables us to rule out musculoskeletal infection with 99% certainty in limping children with none of these three presenting variables.en_GB
dc.language.isoengen_GB
dc.subject.meshAlgorithmsen_GB
dc.subject.meshArthritis, Infectious/diagnosisen_GB
dc.subject.meshBone Diseases, Infectious/*diagnosisen_GB
dc.subject.meshC-Reactive Protein/analysisen_GB
dc.subject.meshChilden_GB
dc.subject.meshChild, Preschoolen_GB
dc.subject.meshFemaleen_GB
dc.subject.mesh*Gaiten_GB
dc.subject.meshHumansen_GB
dc.subject.meshInfanten_GB
dc.subject.meshMaleen_GB
dc.subject.meshMultivariate Analysisen_GB
dc.subject.meshMuscular Diseases/*diagnosisen_GB
dc.subject.meshOsteomyelitis/diagnosisen_GB
dc.titleThe limping child: an algorithm to outrule musculoskeletal sepsis.en_GB
dc.contributor.departmentDepartment of Trauma and Orthopaedics, Cork University Hospital, Cork, Ireland., Delaney.ruth@gmail.comen_GB
dc.identifier.journalIrish journal of medical scienceen_GB
dc.description.provinceMunster-

Related articles on PubMed

All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.