Musculoskeletal infections, including septic arthritis, osteomyelitis, and soft tissue infections, are critical morbidity factors for children and adolescents. This study investigated the role of D-dimer levels for diagnosing childhood musculoskeletal infections. This single-center prospective study was initiated in April 2020 following approval from the local ethics committee. The study included 54 children, divided into the infection group (n = 21), comprising patients who underwent surgical treatment for childhood musculoskeletal infections and had macroscopically visible purulent discharge during surgery, and the control group (n = 33), comprising healthy children. In the infection group, the mean values of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), plasma D-dimer, and white blood cell (WBC) were 39.42 ± 27.00 mm/h, 101.50 ± 76.90 mg/l, 2.34 ± 2.59 mg/l, and 15.55 ± 6.86 × 10⁹/l, respectively. On comparison, the infection group showed higher levels of WBC, CRP, ESR, D-dimer, and neutrophil-to-lymphocyte ratio than the control group. When the D-dimer cutoff value of 0.43 mg/l was taken, it was observed that it had 95.2% sensitivity and 81.8% specificity. The area under curve (AUC) of the above-mentioned parameters calculated via receiver operating characteristic curves showed CRP levels as the optimum predictor of childhood musculoskeletal infections, followed by the ESR, plasma D-dimer, and WBC levels in descending order (AUC: 0.999, 0.997, 0.986, and 0.935, respectively). D-dimer is another test, which in combination with other conventional established tests (CRP and ESR) can be helpful in diagnosis of pediatric infection. We recommend the addition of D-Dimer to ESR, CRP, and WBC as a first-line investigation in cases with suspected pediatric musculoskeletal infections.

肌肉骨骼感染，包括化脓性关节炎、骨髓炎和软组织感染，是儿童和青少年的重要发病因素。本研究调查了 D-二聚体水平在诊断儿童肌肉骨骼感染中的作用。这项单中心前瞻性研究经当地伦理委员会批准后于 2020 年 4 月启动。该研究包括 54 名儿童，分为感染组（n = 21），包括因儿童肌肉骨骼感染接受手术治疗并在手术过程中肉眼可见脓性分泌物的患者，以及对照组（n= 33)，包括健康儿童。感染组红细胞沉降率（ESR）、C反应蛋白（CRP）、血浆D-二聚体和白细胞（WBC）的平均值分别为39.42±27.00 mm/h、101.50±76.90 mg/l , 2.34 ± 2.59 毫克/升, 和 15.55 ± 6.86 × 10 ⁹/升，分别。相比之下，感染组的 WBC、CRP、ESR、D-二聚体和中性粒细胞与淋巴细胞比值均高于对照组。当取 0.43 mg/l 的 D-二聚体截止值时，观察到它具有 95.2% 的敏感性和 81.8% 的特异性。通过接受者操作特征曲线计算的上述参数的曲线下面积 (AUC) 显示 CRP 水平是儿童肌肉骨骼感染的最佳预测因子，其次是 ESR、血浆 D-二聚体和 WBC 水平，降序排列（AUC：分别为 0.999、0.997、0.986 和 0.935）。D-二聚体是另一种测试，它与其他已建立的常规测试（CRP 和 ESR）相结合，有助于诊断儿科感染。我们建议在 ESR、CRP、