Osteomyelitis in sickle cell anemia is due to.

(A)- Musculoskeletal abnormalities in Sickle cell disease.1. Dactylitis or hand-foot syndrome is swelling, tenderness and warmth of hands and feet (<5 years age group).2. Sterile joint effusion and periarticular pain in sickle cell crisis (knee and elbow are usually involved).3. Diaphyseal osteomyelitis of long tubular bone esp. Salmonella infections, also it can involve multiple bones.4. Infarction of bone marrow and avascular necrosis.