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ORIGINAL ARTICLE
Year : 2019  |  Volume : 11  |  Issue : 2  |  Page : 95-99

Role of quantitative c-reactive protein and erythrocyte sedimentation rate for evaluation and management of acute osteoarticular infections in pediatric patients


1 Department of Orthopaedics and Traumatology, M.G.M. Medical College and M.Y. Hospital, Indore, Madhya Pradesh, India
2 Department of Biochemistry, M.G.M. Medical College and M.Y. Hospital, Indore, Madhya Pradesh, India

Correspondence Address:
Dr. Vipin Mishra
Department of Orthopaedics and Traumatology, M.G.M. Medical College and M.Y. Hospital, Indore, Madhya Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jotr.jotr_25_19

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Background: Acute bone and joint infections in children are at times difficult to diagnose and pose serious consequences if not diagnosed and treated in time. We conducted a prospective and observational study from September 2016 to July 2018. Aims and Objects: Our study included 30 children between the ages of 3 months and 14 years, with suspected acute osteoarticular infection, with a predetermined series of ESR, CRP measurements. Material and Methods: 21 patient had a diagnosis of acute septic arthritis (SA) (70%) and 9 patient had acute osteomyelitis (OM) (30%). Boys were predominantly affected (63% boys as compared to 37 % girls), and the mean age was 6.65 years. The average ESR on day of admission, 3rd, 10th, 28th day and two month was 35 mm, 41 mm, 28mm, 18mm and 13mm at one hour respectively. Average CRP on day of admission, 3rd, 10th, 28th day and two month was 80mg/l, 54mg/l, 17.6mg/l, 8mg/l, 5.5mg/l respectively. Results: The observed peaks of the ESR reached on day 3 and peak in CRP titre generally was seen on day of admission. After peaking, ESR started a slow descent; the <20-mm/hour level was reached on day 28. CRP started a more rapid normalization, descending to less than 20 mg/L in 10 days. CRP normalizes faster than ESR, providing a clear advantage in monitoring recovery. CRP normalized earlier in patients with OM, whereas normalization was slower in patients with SA. Conclusion: Serial measurements of ESR and CRP not only help in diagnosing Acute bone and joint infections in children but also help in monitoring response to treatment and duration of antibiotics.


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