What is Known:
• Magnetic resonance imaging and sonography have the best sensitivity for detection of acute osteomyelitis and septic arthritis in children.
• Systematic use of blood cultures, tissue cultures and nucleic acid testing improves pathogen detection in children with acute osteomyelitis and septic arthritis.
What is New:
• The added value of imaging modalities other than magnetic resonance and sonography for detection of osteomyelitis and septic arthritis is limited, and their routine use should be questioned.
• Despite availability of optimal pathogen detection methods, missed opportunities to improve pathogen detection are frequent.