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The most common type of osteomyelitis, an infection of bone, that occurs in children is acute hematogenous osteomyelitis. Infection initially is established in the metaphyseal region of tubular bones, beginning as a metaphysitis following seeding by bacteria. The appendicular skeleton is the most common site of osteomyelitis. The lower extremity, especially the femur, is involved more often than the upper extremity, where the humerus is most likely to be infected. The pelvic bones or clavicles are less likely to be involved than the long bones of the extremities. The most common bone involved in acute hematogenous osteomyelitis in children is the femur. The axial skeleton is less likely to be the site of acute hematogenous osteomyelitis. Manifestations of osteomyelitis involving the axial skeleton are most commonly discitis, vertebral osteomyelitis, and infection involving the ribs and cranial bones.

In most cases, the...

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