Our three-year-old daughter stopped walking all of a sudden last week. The doctor diagnosed her with a urinary tract infection that caused an abscess in her hip muscle. They had to do surgery to lance the abscess and drain it. She’s also on antibiotics. I’ve agonized over this decision ever since. Could the antibiotic have taken care of the problem without the surgery? Could we have avoided the antibiotics and just had the abscess removed?

The decision to treat musculoskeletal abscesses surgically is usually based on modern diagnostic techniques. Ultrasound and MRIs make it possible now to see when the condition is serious enough to recommend surgery. In some cases, early surgery results in fewer complications and problems.

Fluid in the joints called effusion seen on MRIs indicate the start of septic arthritis (joint infection). Likewise, an abscess in the bone can be identified with this type of advanced imaging. The spread of the bacteria from the abscess to other parts of the body is not uncommon. But it can be a serious problem. Bone infections are often accompanied by blood clots. Both the infectious process and the blood clot can be life-threatening — even in a young child.

Studies have shown that early signs of joint effusion tells the doctor that antibiotic treatment alone is not likely to be effective. That’s when combining drug treatment with surgery is advised. It sounds like your physician helped you make the best treatment decision possible under the circumstances.

Best practice based on the most up-to-date evidence requires the use of antibiotics for musculoskeletal infections. The real decision is which antibiotic is best for the bacteria present and whether the drug should be oral (taken by mouth) or intravenous. You can rely on your physician to make this decision.