Commonest site of bone involvement in hematogenous osteomyelitis:

Ans is 'a' i.e. Metaphysis Repeat from May 09Acute osteomyelitis is almost invariably a disease of children. When adults are affected it may be because their resistance is lowered by debility, disease or drugs.Acute osteomyelitis may result from hematogenous spread of the infecting organism, or may be infected secondarily from the spread of a contiguous area of infection, or direct inoculation of bacteria in the bone (open fractures, nail punctures of the foot).Hematogenous spread is the commonest means of production of osteomyelitis.Commonest site is metaphysis. This is because of the peculiar arrangement of the blood vessels in that area, which leads to relative vascular stasis, favouring bacterial colonization. - Commonest site: Lower femoral metaphyses > Upper tibial, upper femoral, upper humeral metaphyses.Acute hematogenous osteomyelitis behaves differently in neonates from the way it does in children. Because blood vessels cross the growth plate in neonates and infants younger than age 18 months, the bone infection that develops in that age group will likely cross the physis; however, in older children, acute infections rarely cross the growth plate.In adults, hematogenous infection is more common in the vertebrae than in the long bones.