How can we differentiate between sickle cell crisis and septic arthritis/osteomyelitis (OM)?

Author: Mahzad Javid

RECOMMENDATION: A combination of clinical, laboratory and imaging studies are all needed for differentiating between sickle cell crisis and infection. A positive aspiration for infection from the joint or periosteum confirms the presence of infection while sequential ultrasounds in the absence of sub-periosteal fluid collection favor sickle cell crisis. Tri-phasic bone scan in the fi rst 24 hours can differentiate vaso-occlusive crisis (VOC) from acute infection. Contrast enhanced magnetic resonance imaging (MRI) is fairly accurate in differentiating infection from infarction.

LEVEL OF EVIDENCE: Moderate

DELEGATE VOTE: Agree: 87%, Disagree: 0%, Abstain: 13% (Super Majority, Strong Consensus)

Peds-8