BMUS: The Burden of Musculoskeletal Diseases in the United States
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Musculoskeletal Infections

VII.B.1.0
Children & Adolescents

Lead Author(s): 

Scott B. Rosenfeld, MD

Supporting Author(s): 

Sylvia I. Watkins-Castillo, PhD
Musculoskeletal infections included in this section are osteomyelitis, septic arthritis, soft tissue infections (myositis), Lyme disease, and tuberculosis. Osteomyelitis and septic arthritis are the most common form of pediatric musculoskeletal infections and most commonly occur in the first decade of life in previously healthy children. Lyme disease is caused by a bite from a deer tick and is less common than osteomyelitis and septic arthritis. It is more prevalent in the Northeastern and Midwestern regions of the United States.1 Tuberculosis (TB) has become much less common in the United States over the last few decades, but has increased in incidence in developing countries secondary to immunodeficiency and multidrug resistance. TB infections involve the musculoskeletal system in 2% to 5% of cases.2 Community-acquired Staphylococcus aureus (CA-SA) is the most common infecting organism in pediatric musculoskeletal infections and is typically treated with a first-generation cephalosporin, such as cefazolin. Over the past decade methicillin-resistant Staphylococcus aureus (MRSA) has become prevalent and requires treatment with second-line antibiotics such as clindamycin or vancomycin.3 As MRSA infections have become more prevalent, the disease course for patients with these infections has become much more severe, with greater systemic disease requiring multimodal and multidisciplinary treatments including medical, surgical, and critical care. Patients are often hospitalized for extended periods and most require continued care with long-term antibiotic treatment after discharge. Complications of musculoskeletal infections include growth deformity, fractures, and arthritis, and may result in long-term morbidity and dysfunction.
  • 1. Willis AA, Widmann RF, Flynn JM, Green DW, Onel KB: Lyme arthritis presenting as acute septic arthritis in children. J Pediatr Orthop 2003 Jan-Feb;23(1):114-118.
  • 2. Rasool MN: Osseous manifestations of tuberculosis in children. J Pediatr Orthop 2001 Nov-Dec;21(6):749-755.
  • 3. Copley LA: Pediatric musculoskeletal infection: Trends and antibiotic recommendations. JAAOS 2009 Oct;17(10):618-626. PubMed PMID: 19794219. Epub 2009/10/02. eng.

Edition: 

  • 2014

Health Care Utilization

VII.B.1.1
Children & Adolescents Musculoskeletal Infections

Lead Author(s): 

Scott B. Rosenfeld, MD

Supporting Author(s): 

Sylvia I. Watkins-Castillo, PhD

Musculoskeletal infections were diagnosed in 119,900 children and adolescent health care visits in 2012, of which 78,800 had a primary diagnosis of musculoskeletal infection. Of this total, 14,900 children and adolescents were hospital discharges, with 9,100 hospitalizations for a primary diagnosis of a musculoskeletal infection. (Reference Table 7.1.1 PDF [1] CSV [2] and Table 7.1.2 PDF [3] CSV [4])

Males were more likely to be hospitalized with a musculoskeletal infection than females, as were children between the ages of 1 and 10 years. Musculoskeletal infections as a primary diagnosis accounted for 1.8% of hospital discharges for any musculoskeletal-related condition, but only 0.1% of hospital discharges for all health care reasons for children and adolescents age 20 years and younger. (Reference Table 7.2 PDF [5] CSV [6])

Hospital Discharges for Children and Adolescents Age 20 and Under with Musculoskeletal (MSK) Infection Diagnosis, by Sex and Age, United States 2012

Edition: 

  • 2014

Hospital Charges

VII.B.1.2
Children & Adolescents Musculoskeletal Infections

Lead Author(s): 

Scott B. Rosenfeld, MD

Supporting Author(s): 

Sylvia I. Watkins-Castillo, PhD

Total charges averaged $70,700 for a mean 8.5-day stay when children and adolescents were hospitalized with a diagnosis of musculoskeletal infection along with other medical conditions. With a primary diagnosis of infection, the stay was shorter (6.3 days), and mean charges were $46,000. Total hospital charges for all primary musculoskeletal infection discharges in 2012 were $419 million. (Reference Table 7.2 PDF [5] CSV [6])

Total Hospital Charges for Children and Adolescents Age 20 and Under with Musculoskeletal (MSK) Infection Diagnosis, by Sex and Age, United States 2012

Edition: 

  • 2014
The Burden of Musculoskeletal Diseases in the United States - Copyright © 2014.

Source URL: https://bmus.latticegroup.com/2013-report/patient-co-morbidities/vii2b

Links:
[1] https://bmus.latticegroup.com/docs/T7.1.1.pdf
[2] https://bmus.latticegroup.com/docs/T7.1.1.csv
[3] https://bmus.latticegroup.com/docs/T7.1.2.pdf
[4] https://bmus.latticegroup.com/docs/T7.1.2.csv
[5] https://bmus.latticegroup.com/docs/T7.2.pdf
[6] https://bmus.latticegroup.com/docs/T7.2.csv