Are there conditions where the erythrocyte sedimentation rate (ESR) and other blood tests are unreliable for diagnosis of pediatric musculoskeletal infections?

Authors: Ali Parsa, Mohammad Hammad

RECOMMENDATION: Yes. Serum tests including ESR, C-reactive protein (CRP) and absolute white blood cell (WBC) count might be unreliable for diagnosis of pediatric musculoskeletal infections in neonates, patients with rheumatological disease, post-trauma, post-surgery, patients with Lyme arthritis and those receiving intravenous immunoglobulin (IVIG) administration.

LEVEL OF EVIDENCE: Moderate

DELEGATE VOTE: Agree: 88%, Disagree: 3%, Abstain: 9% (Super Majority, Strong Consensus)

Peds-3