Musculoskeletal Infection

Clinical Pathways promote evidence based, safe, and high-value care for patients by providing clinical recommendations and standard processes. They are developed by multidisciplinary committees of subject matter experts, informed by methodical review of available evidence and consensus among committee members. 

Clinical Pathway: 

• Musculoskeletal Infection Algorithm
• Musculoskeletal Infection Synopsis (provides care standards employed for this clinical pathway)

Inclusion and exclusion criteria:

Inclusion:  

• Patients with concern for acute or subacute musculoskeletal (MSK) infection including:
  • Osteomyelitis
  • Septic arthritis

Exclusion:  

• Chronic MSK infection (> 6 weeks)
• Sepsis (see Sepsis Clinical Pathway)
• Necrotizing fasciitis (contact Orthopedic Surgery and Infectious Diseases immediately)
• Post-operative infection
• Surgical hardware
• Infection associated with foreign body
• Infections from penetrating trauma
• Decubitus ulcers
• Sickle Cell Disease
• Neonates

Committee members involved in the development: 

• Douglas Swanson, MD | Infectious Diseases | Committee Chair
• Lisa Berglund, MD | Orthopedic Surgery | Committee Member
• Jenna Bishop, PharmD | Pharmacy | Committee Member
• Ali Fowler, MD | Pediatric Resident | Committee Member
• Margaret Hainline, MD | Hospital Medicine | Committee Member
• Neena Kanwar, PhD | Laboratory Medicine | Committee Member
• Viet Le, MD | Radiology | Committee Member
• Lina Patel, MD | Emergency Medicine | Committee Member
• Kedar Tilak, MD, FAAP | Infectious Diseases / Neonatology | Committee Member

EBP Committee Members:

• Kathleen Berg, MD, FAAP | Hospitalist, Evidence Based Practice
• Kori Hess, PharmD | Evidence Based Practice

Publication dates: 

• Finalized date: 11/2018; 6/2019; 9/2020; 1/2022; 7/2025
• Next expected revision date: 2028

If you have any questions regarding this content, or identify a broken link, please email evidencebasedpractice@cmh.edu. 

These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.