Acute osteomyelitis and septic arthritis in children: a systematic review of systematic reviews

Eur Rev Med Pharmacol Sci. 2019 Apr;23(2 Suppl):145-158. doi: 10.26355/eurrev_201904_17484.


Objective: Septic arthritis and osteomyelitis are rare in children, but they are difficult to treat and are associated with a high rate of sequelae. This paper addresses the main clinical issues related to septic arthritis and osteomyelitis by means of a systematic review of systematic reviews.

Materials and methods: The major electronic databases were searched for systematic reviews/meta-analyses septic arthritis and osteomyelitis. The papers that fulfilled the inclusion/exclusion criteria were selected.

Results: There were four systematic reviews on septic arthritis and four on osteomyelitis. Independent assessment of their methodological quality by two reviewers using AMSTAR 2 indicated that its criteria were not consistently followed.

Conclusions: Collectively, these works provide strong evidence regarding a large number of issues including classification, epidemiology and risk factors, causative organisms, clinical presentation, laboratory markers, imaging, diagnostic needle aspiration, antibiotic therapy, surgical therapy, and prognosis. A clinical summary based on the best evidence is supplied.

Publication types

  • Systematic Review

MeSH terms

  • Acute Disease
  • Arthritis, Infectious* / diagnosis
  • Arthritis, Infectious* / drug therapy
  • Arthritis, Infectious* / surgery
  • Child
  • Humans
  • Osteomyelitis* / diagnosis
  • Osteomyelitis* / drug therapy
  • Osteomyelitis* / surgery