Osteomyelitis of the talus: an unusual cause of limping in childhood.

Hematogenous osteomyelitis of the talus is a rare and infrequently considered cause of limping in children. We describe five children younger than 2 years of age with osteomyelitis of the talus who had a limp and a paucity of constitutional symptoms. Conventional radiography and scintigraphy were the imaging techniques used. The usual radiologic features include soft-tissue swelling and an osteolytic defect in the talus without sequestrum formation of periosteal reaction. Bone scans were positive in all cases and led to the localization of the lesion in two patients. Definitive diagnosis was made in all cases only after needle aspiration or open biopsy and curettage. Increased awareness of this unusual lesion and its subtle early radiologic manifestations will allow prompt diagnosis and treatment.