Fever and Limp-Review of Children’s Musculoskeletal Guidelines

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BY Mike Mallory

michael.mallory@pemaweb.com

 

A 3-year-old comes to your office with a fever and a limp.  Parents noticed a little discomfort yesterday, but it’s worse today and now the child doesn’t want to bear weight.  What is the work up that we need to do?  That is the question that the recently finalized Musculoskeletal (MSK) Infection clinical practice guideline attempts to answer.

The first question that the guideline asks us is to determine our level of suspicion for risk of MSK infection.  The following historical and exam features should raise suspicion of MSK infection.

History:

Pain, fever, inability to bear weight, gait disturbance/limp, limited use of extremity, immobility of extremity, travel to area with endemic Lyme disease.

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