In pediatric osteomyelitis, which joint is most commonly affected?

• A. Hip
• B. Knee
• C. Ankle
• D. Shoulder

Answer: (A)

In pediatric osteomyelitis, infection reaches the bone through the bloodstream and most often seeds the metaphysis of long bones. When this happens near the proximal femur, the infection can extend directly into the hip joint because of the close anatomic relationship and the hip’s vascular-rich, synovial environment. That propensity for spread makes the hip joint the one most commonly affected by septic extension in children with osteomyelitis. Clinically, this means feeling or imaging signs of joint involvement are especially important when osteomyelitis is suspected in the proximal femur, and prompt assessment for septic arthritis with appropriate antibiotics is essential.