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dc.contributor.authorDelaney, R A
dc.contributor.authorLenehan, B
dc.contributor.authorO'sullivan, L
dc.contributor.authorMcGuinness, A J
dc.contributor.authorStreet, J T
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.
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
html.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.


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