The Journal of Bone and Joint Surgery, Vol 76, Issue 6 848-853, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc
The usefulness of C-reactive protein levels in the identification of concurrent septic arthritis in children who have acute hematogenous osteomyelitis. A comparison with the usefulness of the erythrocyte sedimentation rate and the white blood-cell count
L Unkila-Kallio, MJ Kallio and H Peltola
Division of Infectious Diseases, Children's Hospital, University of Helsinki, Finland.
Thirty-six children who had bacteriologically confirmed acute hematogenous
osteomyelitis but did not have concurrent septic arthritis, and ten
children who had confirmed acute hematogenous osteomyelitis and concurrent
septic arthritis, were followed for one year to compare the changes in the
C-reactive protein level in the blood, the erythrocyte sedimentation rate,
and the white blood-cell count. In both groups, the mean C-reactive-protein
values were high (eighty-four milligrams per liter in the children who had
septic arthritis and osteomyelitis and sixty-five milligrams per liter in
those who had osteomyelitis only) at the time of admission to the hospital.
However, in the group that had septic arthritis, the increase was
significantly higher (p < 0.01) as early as the second day and a normal
level (less than twenty milligrams per liter) was reached significantly
later (p < 0.001) than in the group that had osteomyelitis only (11 +/-
7 days compared with 6 +/- 3 days [mean and standard deviation]). The
erythrocyte sedimentation rate showed the same tendency, but the difference
in the rates between the groups did not become evident until the fifth to
fourteenth days after admission. A normal erythrocyte sedimentation rate
(less than twenty millimeters per hour) was reached in 25 +/- 12 days in
the children who had septic arthritis and in 17 +/- 10 days in those who
did not (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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