Osteomyelitis of the pelvis and proximal femur: Diagnostic difficulties

Osteomyelitis of the pelvis or proximal femur may still be diagnosed late b ecause the infection is deeply placed and investigations may concentrate so lely upon the possibility of septic arthritis. Periacetabular infection was diagnosed in 16 children between 1993, and 1998. A high index of suspicion and the use Of appropriate imaging will ensure that the condition is not a llowed to progress, although in this series one child underwent an unnecess ary appendicectomy, and a subsequent sepsis of the hip joint was drained in another case. Radiographs of the pelvis were rarely abnormal within 7 days of the onset of symptoms and an ultrasound scan focused on the hip joint m ay miss the periarticular changes.