AN OBSERVATIONAL COMPARATIVE STUDY OF CRP AND ESR IN EVALUATION AND MANAGEMENT OF ACUTE BONE AND JOINT INFECTION IN PEDIATRIC PATIENTS IN TERTIARY CARE CENTRE OF CENTRAL INDIA

Introduction :Acute osteomyelitis of childhood usually affects the long bones of the lower limbs. Although almost any agent may cause acute osteomyelitis, Staphylococcus aureus is the most common bacteria. We conducted a prospective and observational study from July 2019-January 2021. Aims and Objects: Our studyincluded 36 children between the ages of 5 months and 14 years, with suspected acute osteoarticular infection, with a predetermined seriesof ESR, CRP measurements. Material and Methods:We included 36 patients in our study out of which 25 patient had a diagnosis of acute osteomyelitis (70%) and 11 patient had acuteseptic arthritis(SA) (30%). Boyswere predominantly affected (64% boys as compared to 36 % girls), and the mean age was 6.12 years. Theaverage ESR on day of admission, 3rd, 10th, one month and two month was 36 mm, 51 mm, 37mm, 20mm and 14 mm at one hour respectively.Average CRP on day of admission, 3rd, 10th, one month and two month was 86 mg/l, 64mg/l, 19.6mg/l, 10mg/l, 5mg/l respectively. Results: Theobserved 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 slowdescent the <20-mm/hour level was reached on end of one month. 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, where as normalization was slower in patients with SA. Conclusion: Serial measurements of ESR and CRP not only help in diagnosing Acute boneand joint infections in children but also help in monitoring response to treatment and duration of antibiotics.