Pediatric Chronic Osteomyelitis: An Introduction

Chronic osteomyelitis in children can be a devastating disease as it may lead to major bone loss, bony deformities, partial or complete growth plate arrest, nonunion, and significant limb length discrepancy. Function can be severely affected, and on a worldwide scale, it remains one of the most crippling and devastating musculoskeletal conditions. The key to prevention of chronic osteomyelitis remains proper management of the infection during the acute phase. Any sick child with bony tenderness should be suspected as having acute osteomyelitis until proven otherwise, and antibiotics should be started immediately after appropriate cultures are obtained. If there is no clinical and laboratory response within 24–48 h, then either the causative organisms are not sensitive to the given antibiotics or a subperiosteal abscess has developed, and this has to be addressed.