osteoporosis described in adults, especially early after the onset of symptoms Radionuclide bone scans generally show increased blood flow and periarticular uptake in adults, but in children with CRPS1 the blood flow and osseous uptake is more often reduced Thermography may document decreased temperature in the affected extremity Management Treatment of CRPS1 focuses on early mobilization of the extremity through physical therapy to avoid atrophic changes Physiotherapy may initially exacerbate symptoms, but experienced clinicians believe it both prevents atrophy and decreases the duration of pain The knee-jerk response to splint for comfort may be counterproductive with CRPS1 Referral to a pediatric pain program is advisable if symptoms persist Sympathetic block with local anesthetic is commonly performed in patients with CRPS1 but evidence of effectiveness is lacking There are case reports of successful treatment of CRPS1 with intravenous regional block using guanethidine, transcutaneous nerve stimulation, and sympathectomy Suggested Readings and Key References Osteomyelitis McNeil JC, Forbes AR, Vallejo JG, et al Role of operative or interventional radiology-guided cultures for osteomyelitis Pediatrics 2016;137(5):e20154616 Peltola H, Paakkonen M Acute osteomyelitis in children N Engl J Med 2014;370(4):352–360 Quick RD, Williams J, Fernandez M, et al Improved diagnosis and treatment of bone and joint infections using an evidence-based treatment guideline J Pediatr Orthop 2018;38(6):e354–e359 Saavedra-Lozano J, Falup-Pecurariu O, Faust SN, et al Bone and joint infections Pediatr Infect Dis J 2017;36(8):788–799 Whyte NSB, Bielski RJ Acute hematogenous osteomyelitis in children Pediatr Ann 2016;45(6):e204–e208 Septic Arthritis Carter K, Doern C, Jo C, et al The clinical usefulness of polymerase chain reaction as a supplemental diagnostic tool in the evaluation and the treatment of children with septic arthritis J Pediatr Orthop 2016;36(2):167–172