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Review
. 2018 Nov;36(4):751-766.
doi: 10.1016/j.emc.2018.06.006. Epub 2018 Sep 6.

Musculoskeletal Infections in the Emergency Department

Daniel C Kolinsky  1 , Stephen Y Liang  2
Affiliations
Review

Musculoskeletal Infections in the Emergency Department

Daniel C Kolinsky et al. Emerg Med Clin North Am. 2018 Nov.

Abstract

Bone and joint infections are potentially limb-threatening or even life-threatening diseases. Emergency physicians must consider infection when evaluating musculoskeletal complaints, as misdiagnosis can have significant consequences. Patients with bone and joint infections can have heterogeneous presentations with nonspecific signs and symptoms. Staphylococcus aureus is the most commonly implicated microorganism. Although diagnosis may be suggested by physical examination, laboratory testing, and imaging, tissue sampling for Gram stain and microbiologic culture is preferable, as pathogen identification and susceptibility testing help optimize long-term antibiotic therapy. A combination of medical and surgical interventions is often necessary to effectively manage these challenging infections.

Keywords: Emergency department; Osteomyelitis; Periprosthetic joint infection; Posttraumatic osteomyelitis; Septic arthritis; Spinal epidural abscess; Spondylodiscitis.

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Conflict of interest statement

Disclosure statement:

D.C.K. reports no conflicts of interest and no financial disclosures in this work. S.Y.L. reports no conflicts of interest in this work. S.Y.L. is the recipient of a KM1 Comparative Effectiveness Research Career Development Award (KM1CA156708-01) and received support through the Clinical and Translational Science Award (CTSA) program (UL1RR024992) of the National Center for Advancing Translational Sciences as well as the Barnes-Jewish Patient Safety & Quality Career Development Program, which is funded by the Foundation for Barnes-Jewish Hospital.

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