Childhood osteomyelitis and septic arthritis.

The diagnosis, treatment, and monitoring of septic arthritis or osteomyelitis in children has become more streamlined in recent years. C-reactive protein appears to be a better laboratory study than sedimentation rate in the diagnosis of bone or joint infection and in monitoring a patient's clinical response to antibiotics. Oral antibiotics may be rapidly substituted for intravenous antibiotics in patients who have a identifiable sensitive organism, who show rapid clinical improvement, and who show rapid normalization of C-reactive protein. The physician must remain alert for resistant organisms, highly virulent organisms (post-varicella streptococcal infections) and rare organisms.