Paediatrics - Queensland Health - Queensland Government
Paediatrics - Queensland Health - Queensland Government
Paediatrics - Queensland Health - Queensland Government
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Bone and joint problems<br />
630<br />
See next MO clinic<br />
Routine prophylaxis is no longer recommended [1]<br />
6. Referral / consultation<br />
Consult MO on all occasions of suspected UTI in children<br />
All children with confirmed UTI require referral to Paediatrician<br />
All children < 6 months of age should have a renal ultrasound<br />
Consider renal ultrasound for older children with first UTI [1]<br />
Micturating cysto-urethrogram (MCU) or nuclear medicine scan may be necessary<br />
but the decision to perform this needs to be individualised in consultation with<br />
Paediatrician [1]<br />
References<br />
1. The Royal Children’s Hospital Melbourne. Urinary Tract Infection Guideline. 2008 [cited 2011 January];<br />
8th edition: Available from: www.rch.org.au/clinicalguide/cpg.cfm?doc_id=5241.<br />
2. Therapeutic Guidelines. Urinary tract infections: children 2010 [cited 2011 January].<br />
3. NHS choices. Urinary tract infection, children. 2010 [cited 2011]; April]. Available from: www.nhs.uk/<br />
Conditions/Urinary-tract-infection-children/Pages/Symptoms.aspx.<br />
4. Royal Children’s Hospital, AntibioCard. 2011: Brisbane.<br />
Bone or joint infections - child<br />
Osteomyelitis and septic arthritis<br />
Recommend<br />
Referral to Orthopaedic Specialist if suspected osteomyelitis / septic arthritis [1]<br />
An important consideration if a skin infection is taking a long time to resolve, or<br />
occurs over a joint<br />
Background<br />
Osteomyelitis and septic arthritis can affect any joint or bone, but most commonly<br />
involve the lower limbs [1]<br />
Polyarthritis or aseptic monoarthritis or polyarthralgia, usually migratory (finishes in<br />
one joint and then begins in another) is a major manifestation of acute rheumatic<br />
fever (ARF) [2]<br />
Related topics<br />
Bacterial skin infections<br />
Acute rheumatic fever (ARF)<br />
1. May present with [1]<br />
Osteomyelitis<br />
• Subacute onset of limp / nonweight<br />
bearing / refusal to use limb<br />
• Localised pain and pain on<br />
movement<br />
• Tenderness<br />
• Soft tissue redness / swelling may<br />
not be present and may appear<br />
late<br />
• + / - fever<br />
2. Immediate management<br />
• Consult MO<br />
Controlled copy V1.0<br />
Septic arthritis<br />
• Acute onset of limp / non-weight<br />
bearing / refusal to use limb<br />
• Pain on movement and at rest<br />
• Limited range / loss of movement<br />
• Soft tissue redness / swelling often<br />
present<br />
• Fever<br />
Primary Clinical Care Manual 2011
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