Bacteria can “infect” the bone or the joint in a contamination process similar to the way in which infection attacks the throat, lungs, urinary tract or any other tissue. In medical terms, these conditions are referred to as osteomyelitis (when it’s a bone infection) and septic arthritis (when it’s a joint infection.)

There are two main ways in which bacterial infection reaches these tissues. The most common is through the blood stream. The bacteria infiltrate the blood stream – throat sores, tooth infection, etc. – or via the gastrointestinal wall, and once they are in the blood they can then nest in the various tissues.

The unique blood supply to the bones and joints in children raises the risk of bacterial infection in these tissues. Another way of contracting infection is through “direct infection,” when the bacteria comes from outside the body directly into the bone. For example, after a deep wound down to the bone or the joint.

The infection process in joints can destroy the joint cartilage, cause pain and limit movement as the child grows. In bones, the infection is usually slow in developing and affects the normal growth of the bone. It could also spread to nearby tissue. In both types of infection there is a risk of spreading back into the blood and from there to other tissues.


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In most cases, these processes manifest themselves through pain, high temperature, sensitivity or swelling in the infected area and blood test results indicating an infection process. There are other cases in which these symptoms are minimal and the only sign may be a limp or some discomfort in moving the limb.

X-rays taken soon after noticing the infection will largely show normal results. Only after a couple of weeks will there typically be changes in the bone structure (see picture). An ultrasound will allow the doctor to locate fluid in the joint and the accumulation of pus around the bone. An MRI will be used mainly to simulate bone marrow and help identify any infection process already in its early stages.

In the majority of cases, the infecting bacteria are common ‘offenders’ and can be eradicated with regular antibiotics. At first the treatment will be intravenous and we will administer oral antibiotics when the child shows signs of recovery. We also add localized treatment such as draining the joint or the bone and cleaning away the pus.

Treating these infections can take a few weeks or even months, due to their tendency to become chronic if all the bacteria are not destroyed. In some cases we cannot identify the infecting bacteria and so we base our diagnosis on the child’s general state and give him or her the treatment we would give for the usual bacteria in this illness.

Complications depend mainly on when the treatment is given. Infections that are left untreated, treated late or not treated fully can end in irrevocable damage to the joint or the bone – stunting the lengthening of the bone, leaving a permanent bend in the joint or limiting joint movement. 

To prevent these complications and to give the treatment every chance of success, we ask parents to make sure the child receives the right antibiotic treatment. That he or she swallows it all and doesn’t spit out or vomit the medicine. It is vital to see the course through to the end and not stop beforehand. Likewise, it is important to undergo all the necessary tests administered within the monitoring process. This is the only way we can be sure of the effectiveness of the treatment and see your child recover.

If there are renewed signs of deterioration during the treatment – temperature, difficulties in moving the limb, new swelling or any other signs – tell the medical staff immediately.

This page only offers a general explanation and is no substitute for a personal medical examination and any resultant treatment. This information is intended to help parents better understand the diagnostic and treatment process and to be more involved with it.  
Bacteria can “infect” the bone or the joint in a contamination process similar to the way in which infection attacks the throat, lungs, urinary tract or any other tissue. In medical terms, these conditions are referred to as osteomyelitis (when it’s a bone infection) and septic arthritis (when it’s a joint infection.)

There are two main ways in which bacterial infection reaches these tissues. The most common is through the blood stream. The bacteria infiltrate the blood stream – throat sores, tooth infection, etc. – or via the gastrointestinal wall, and once they are in the blood they can then nest in the various tissues.

The unique blood supply to the bones and joints in children raises the risk of bacterial infection in these tissues. Another way of contracting infection is through “direct infection,” when the bacteria comes from outside the body directly into the bone. For example, after a deep wound down to the bone or the joint.

The infection process in joints can destroy the joint cartilage, cause pain and limit movement as the child grows. In bones, the infection is usually slow in developing and affects the normal growth of the bone. It could also spread to nearby tissue. In both types of infection there is a risk of spreading back into the blood and from there to other tissues.

In most cases, these processes manifest themselves through pain, high temperature, sensitivity or swelling in the infected area and blood test results indicating an infection process. There are other cases in which these symptoms are minimal and the only sign may be a limp or some discomfort in moving the limb.

X-rays taken soon after noticing the infection will largely show normal results. Only after a couple of weeks will there typically be changes in the bone structure (see picture). An ultrasound will allow the doctor to locate fluid in the joint and the accumulation of pus around the bone. An MRI will be used mainly to simulate bone marrow and help identify any infection process already in its early stages.

In the majority of cases, the infecting bacteria are common ‘offenders’ and can be eradicated with regular antibiotics. At first the treatment will be intravenous and we will administer oral antibiotics when the child shows signs of recovery. We also add localized treatment such as draining the joint or the bone and cleaning away the pus.

Treating these infections can take a few weeks or even months, due to their tendency to become chronic if all the bacteria are not destroyed. In some cases we cannot identify the infecting bacteria and so we base our diagnosis on the child’s general state and give him or her the treatment we would give for the usual bacteria in this illness.

Complications depend mainly on when the treatment is given. Infections that are left untreated, treated late or not treated fully can end in irrevocable damage to the joint or the bone – stunting the lengthening of the bone, leaving a permanent bend in the joint or limiting joint movement. 

To prevent these complications and to give the treatment every chance of success, we ask parents to make sure the child receives the right antibiotic treatment. That he or she swallows it all and doesn’t spit out or vomit the medicine. It is vital to see the course through to the end and not stop beforehand. Likewise, it is important to undergo all the necessary tests administered within the monitoring process. This is the only way we can be sure of the effectiveness of the treatment and see your child recover.

If there are renewed signs of deterioration during the treatment – temperature, difficulties in moving the limb, new swelling or any other signs – tell the medical staff immediately.

This page only offers a general explanation and is no substitute for a personal medical examination and any resultant treatment. This information is intended to help parents better understand the diagnostic and treatment process and to be more involved with it.