[Acute osteomyelitis in childhood]

Acute hematogenous osteomyelitis (AHO) is an inflammation of bone caused by bacteria that reach the bone via the hematogenous route. Neonatal osteomyelitis differs from the disease in older children. Staphylococcus aureus is the most predominant organism, accounting for infection in about 80% of patients. The lower extremities are most commonly affected. Because of the intracapsular metaphysis of proximal femur and humerus, there is a higher risk of concomitant septic arthritis in these joints. AHO always means an emergency with high diagnostic and therapeutic demands. The successful outcome depends on early diagnosis and prompt, adequate therapy. Therefore good cooperation with the pediatricians and radiologists is essential. The principles of treatment are symptomatic measures, bedrest and operative intervention, if necessary, with drainage of pus and débridement of any necrotic material, together with antibiotic treatment in sufficient concentration and for sufficient duration. The goal of treatment is to prevent complications such as concomitant septic arthritis with its high risk of persistent joint damage, growth disturbance or chronic osteomyelitis.