Pediatric orthopaedic infection season: An analysis of the seasonal variation of pediatric osteomyelitis and septic arthritis

Some studies have suggested seasonal variations in pediatric orthopaedic infection. We sought to determine if there is seasonal variation in septic arthritis and/or osteomyeltis. We performed a query of a single pediatric hospital's database, identifying all patients diagnosed with septic arthritis and/or osteomyelitis, age 0 through 18, from 1994 through 2010. The institution is located in a temperate climate with definite seasonal variations. Our query yielded 735 pyogenic arthritis and 104 unspecified infective arthritis diagnoses for a total of 839 combined septic arthritis cases. The query yielded 318 acute osteomyelitis, 227 chronic osteomyelitis, and 1114 unspecified osteomyelitis diagnoses for a total of 1659 combined osteomyelitis cases. We identified statistically significant differences in regard to region of body involvement, gender, age, and incidence over time. There was no statistically significant difference with regard to month or season at the time of presentation. There does not appear to be a seasonal variation in the incidence of septic arthritis or osteomyelitis in the pediatric population. This would not support the perception of an "infection season" in pediatric orthopedics. In addition, there is a stable incidence of septic arthritis and an increasing incidence of osteomyelitis noted at our institution over the last 17 years.