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Pediatric Bone and Joint Infections

What are bone infections?

Bone infections, or osteomyelitis, involve inflammation of the bone, usually caused by a bacterial infection. In children, the bacteria are most often Staphylococcus aureus (staph infection) and is primarily carried through the blood.

Preschool-aged children account for about half of bone infection cases because of the rich blood supply in their growing bones. In both children and adolescents, bone infections happen most often in long bones of the legs and arms. If untreated, bone infection can cause severe complications, including:

  • Bone destruction
  • Abscesses (pockets of infected pus)
  • Infected joints (septic arthritis)
  • Deformities and disability resulting from ongoing infections

What causes bone infections?

In addition to staph, other types of bacteria that can cause bone infections include:

  • Group A streptococci (pneumoniae and pyogenes), usually found in the upper respiratory tract
  • Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA), spread by skin-to-skin contact
  • Salmonella, which usually causes gastrointestinal infections
  • Group B streptococci in newborns (passed from mothers during childbirth)

Symptoms of bone infections

The most common symptoms of a bone infection are severe pain and swelling around the infected area. Other symptoms include:

  • Fever and/or chills
  • Soreness, warmth, and redness in the infected area
  • General fatigue
  • Inability to support weight on and move the affected limbs (usually the most noticeable signs in newborns and infants)

How are bone infections diagnosed?

If your child has any of these symptoms, your pediatrician may suspect a bone infection. In older children and adolescents, bone infections can occur after an injury such as a broken bone. Your physician will examine your child and ask about any recent injuries. Other tests that help diagnose bone infection include:

  • Blood tests to check for signs of infection throughout the body
  • X-rays to check for fractures and other problems with bones
  • Diagnostic imaging, especially MRI scans to evaluate bone marrow for inflammation, or CT or bone scans
  • Needle aspiration (sampling bone marrow) or bone biopsy (sampling bone) to determine the type of bone infection

Treatments for bone infections

Once your physician has determined the type of bacteria that is causing your child’s bone infection, he or she can choose the appropriate treatment for it. Some options include:

  • Antibiotics that target specific infections, delivered either intravenously (IV) or orally (by mouth)
  • Surgery for severe bone infections, to drain abscesses or remove segments of dead or infected bone
  • Bone graft to replace dead or infected bone
Learn more about Orthopaedics and Sports Medicine at Children’s National Hospital.
Children's Team

Children's Team


Kaleb Friend

L Kaleb Friend

Orthopaedic Surgeon
Sports Medicine, Foot and Ankle, Orthopaedic Trauma Specialist
Nada Harik

Nada Harik

Director, Fellowship Training Program
Infectious Diseases Specialist
Investigator, Children's National Research Institute
Ben Martin

Benjamin Martin

Associate Chief, Division of Orthopaedic Surgery and Sports Medicine
Spine, Hip, Orthopaedic Trauma Specialist
Jeffrey Peck, M.D.

Jeffrey Peck

Orthopaedic Surgeon
Hip, Spine, Orthopaedic Trauma Specialist
Sean Tabaie

Sean Tabaie

Orthopaedic Surgeon
Cerebral Palsy, Limb Lengthening and Deformity, Orthopaedic Trauma Specialist
Laura Tosi

Laura Tosi

Director, Bone Health Program
Orthopaedic Surgeon
Rare Bone Disease, Bone Health and Orthopaedic Trauma Specialist
Robert Wilson

Robert Wilson

Orthopaedic Surgeon
Hand and Upper Extremity Specialist
Megan Young

Megan Young

Orthopaedic Surgeon
Limb Lengthening and Deformity, Orthopaedic Trauma Specialist


Infectious Diseases

Our Division of Infectious Diseases is the major referral center for infectious diseases in the Washington, D.C., area, helping thousands of patients each year, and actively promoting prevention through community outreach and education.

Orthopaedic Surgery and Sports Medicine

From sprains and strains to complex congenital conditions, Children’s National Hospital offers one of the most experienced pediatric orthopaedic practices in the nation with experience in treating all areas from head to toe.

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