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94: Osteomyelitis and Septic Arthritis
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Published:May 2023
Genevieve L. Buser, MDCM, MSHP, Samir S. Shah, MD, MSCE, FAAP, "Osteomyelitis and Septic Arthritis", Caring for the Hospitalized Child: A Handbook of Inpatient Pediatrics, American Academy of Pediatrics Section on Hospital Medicine, Jeffrey C. Gershel, MD, FAAP, Daniel A. Rauch, MD, FAAP, SFHM
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Osteomyelitis and septic arthritis most commonly occur secondary to hematogenous seeding of bacteria in the bone matrix or joint capsule. Other mechanisms include penetrating trauma or the presence of foreign material (eg, spinal rods). In a patient younger than 18 months, end-loop capillaries feeding the immature epiphysis (transepiphyseal capillaries) allow hematogenous extension of the infection from the epiphysis into the joint capsule. In an older child, septic arthritis may complicate osteomyelitis if a subperiosteal abscess ruptures in a joint where the articular capsule extends over the periosteum (shoulder, elbow, hip, knee). In the lower extremities, concurrent osteomyelitis and septic arthritis...
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