Children's Hospital Colorado

Musculoskeletal Infection Clinical Pathway

Acute hematogenous musculoskeletal infections are deep-seated bacterial infections of the bone (osteomyelitis), joint (septic arthritis) and/or muscle (pyomyositis). These infections arise after bacteria enter the bloodstream and seed a musculoskeletal site to cause acute focal infection.

Objectives of the pathway include:

  • Provide evidence-based guidance for clinicians to offer the best medical and surgical care
  • Increase the likelihood of identifying the bacterial cause for all patients to help target therapy
  • Facilitate multidisciplinary partnerships between medical and surgical teams to provide high-value care

Musculoskeletal Infection clinical pathways

About our Musculoskeletal Infection clinical pathways

Our Musculoskeletal Infection clinical pathway was first implemented in 2012 with the goal of standardizing our diagnostic and therapeutic approach to children with osteomyelitis, septic arthritis and pyomyositis. This pathway is the result of a multidisciplinary collaboration between pediatric orthopedic surgery, infectious diseases, hospital medicine, emergency medicine and radiology. These key stakeholders continue to meet regularly using evidence when available and consensus when needed to continue offering up-to-date guidance to clinicians. 

This pathway includes recommendations for the following components of clinical care: 

  • Diagnostic algorithm to quickly identify patients and target work-up towards high yield studies
  • Management algorithm to provide guidance on the best medical and surgical interventions for specific clinical scenarios
  • Antimicrobial algorithm to steer providers towards targeted therapy based on bacterial source
  • Follow-up algorithm to provide clear expectations at discharge and ensure steady clinical recovery 

The AgileMD format for this pathway aims to integrate this guidance for musculoskeletal infections directly into the provider’s clinical workflow to improve the efficiency of care delivery and make recommendations accessible at the bedside. 

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