{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T04:26:40Z","timestamp":1745987200833,"version":"3.40.4"},"reference-count":0,"publisher":"Pasifika Medical Association Group","issue":"1614","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NZMJ"],"abstract":"<jats:p>aim: To determine the proportion of delayed diagnosis among cases of acute childhood bone and joint infection (BJI) and examine the\nimpact of delayed diagnosis on illness trajectory.\nmethod: A retrospective review was undertaken of patients &lt;16 years with acute haematogenous osteomyelitis (AHO) or septic\narthritis (SA) treated in the Auckland region from 2018\u20132023. Electronic case information was used to identify any alternative diagnosis\ngiven prior to identification of BJI (delayed disease recognition). Cases were grouped into the following subtypes: multifocal sepsis or\nshock, \u201cisolated\u201d AHO or SA, or contiguous local infection such as pyomyositis and subperiosteal abscess. Primary outcomes included\nlength of stay (LOS) and hospitalisation cost.\nresults: A total 563 cases of childhood BJI were identified, of whom 512 had clearly documented presenting complaint. A high\nproportion received an alternative initial diagnosis (43%). Alternatively diagnosed children were more likely to have attended primary\nor urgent care (82% vs 38%, p=0.00001) and have a recent viral illness (46% vs 34%, p=0.008). Receiving alternative diagnosis was\nassociated with greater delay to treatment (7.8 vs 4 days, p=&lt;0.00001). Contiguous local infection was more likely in children with\n&gt;1 week of symptoms (34% vs 17%, p=0.002). Contiguous infection required more surgical intervention, longer LOS and higher\nhospitalisation cost when compared to isolated AHO.\nconclusion: Delayed recognition of childhood AHO and SA is common and is associated with delayed treatment. Symptoms\npresent for &gt;1 week are associated with contiguous infection, which, compared with isolated AHO, requires more surgery with increased\nhospitalisation costs.<\/jats:p>","DOI":"10.26635\/6965.6720","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T02:24:23Z","timestamp":1745979863000},"page":"42-52","source":"Crossref","is-referenced-by-count":0,"title":["Delay to diagnosis in childhood bone and joint infection"],"prefix":"10.26635","volume":"138","author":[{"given":"Sarah","family":"Hunter","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elsie","family":"Brown","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haemish","family":"Crawford","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Selak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cameron","family":"Grant","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"11177","published-online":{"date-parts":[[2025,5,2]]},"container-title":["New Zealand Medical Journal"],"original-title":[],"deposited":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T02:24:26Z","timestamp":1745979866000},"score":1,"resource":{"primary":{"URL":"https:\/\/nzmj.org.nz\/journal\/vol-138-no-1614\/delay-to-diagnosis-in-childhood-bone-and-joint-infection"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,2]]},"references-count":0,"journal-issue":{"issue":"1614","published-online":{"date-parts":[[2025,5,2]]}},"URL":"https:\/\/doi.org\/10.26635\/6965.6720","relation":{},"ISSN":["1175-8716"],"issn-type":[{"value":"1175-8716","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,2]]}}}