Osteomyelitis in children favors the metaphyseal regions because they are hypervascular and consist of small vessels. The small vessels are the most likely place for relative stasis of infected blood to occur and thus, the most commonly encountered focus of bone infection.

Blood markers for infection were elevated and blood cultures positive for Strep pneumoniae.

Pain resolved following treatment with IV antibiotics. 

Repeat plain film (not provided) revealed sclerosis and healing at the femoral metaphysis.