Osteomyelitis — Patient with Suspected Bone Infection — Clinical Pathway: Emergency and Inpatient

Osteomyelitis Clinical Pathway — Emergency Department and Inpatient

Child with Suspected Bone Infection

Patient Cohort

This pathway should be used to guide the evaluation and management of infants or children > 56 days old who exhibit one or more of the following symptoms:

  • Symptom duration < 2 weeks
  • Significant bone pain and/or tenderness with or without warmth and swelling
  • Limp or refusal to bear weight, pseudoparalysis
  • Constitutional symptoms (irritability, decreased activity and/or appetite), especially in infants
  • Fever (absence of fever does not rule out osteomyelitis)

Exclusion Criteria

  • Age ≤ 56 days — see Febrile Infant Pathway
  • Immunocompromised state
  • Recent orthopedic procedure
  • Orthopedic hardware or prosthesis
  • Sickle cell disease
  • Penetrating trauma