Hematogenous osteomyelitis is most commonly begins at which part of the bone?

Hematogenous osteomyelitis is most commonly begins at which part of the bone?

• A. Epiphysis
• B. Diaphysis
• C. Periosteum
• D. Metaphysis

Answer: (D)

Hematogenous osteomyelitis most commonly starts in the metaphysis because of the unique blood supply to the growing bone. In children, the metaphyseal capillary network forms slow-flow, sinusoidal channels that readily trap circulating bacteria, seeding the cancellous bone before the infection can spread. The growth plate (physis) acts as a partial barrier, so the infection tends to begin in the metaphysis and can then extend into the cortex and, if not treated, toward the joint. Epiphyseal and diaphyseal sites are less likely initial targets due to their vascular patterns, and periosteal involvement usually occurs as the infection expands.

Hematogenous osteomyelitis most commonly starts in the metaphysis because of the unique blood supply to the growing bone. In children, the metaphyseal capillary network forms slow-flow, sinusoidal channels that readily trap circulating bacteria, seeding the cancellous bone before the infection can spread. The growth plate (physis) acts as a partial barrier, so the infection tends to begin in the metaphysis and can then extend into the cortex and, if not treated, toward the joint. Epiphyseal and diaphyseal sites are less likely initial targets due to their vascular patterns, and periosteal involvement usually occurs as the infection expands.