Clinical record

An 8-year-old Indigenous Australian boy was transferred from a regional hospital to a metropolitan paediatric hospital, with fevers, 2 weeks of left hip and thigh pain, and a left thigh abscess that had begun to discharge. Two weeks earlier, he had fallen while rollerblading and had sustained a superficial wound on the left thigh. He complained of ongoing left hip and groin pain and presented on several occasions to his general practitioner, who diagnosed a soft tissue injury. On arrival, the patient was in septic shock. Outside-taken radiographs (Figure, A) and magnetic resonance imaging (MRI) (Figure, B) showed extensive osteomyelitis and bony destruction, focused at the left ischium.