Instructional Course LectureUpdate in Pediatric Musculoskeletal Infections: When It Is, When It Isn't, and What to DoArkader, Alexandre MD; Brusalis, Christopher BA; Warner, William C. Jr MD; Conway, James H. MD; Noonan, Kenneth MDAuthor Information This article, as well as other lectures presented at the Academy’s Annual Meeting, will be available in March 2017 in Instructional Course Lectures, Volume 66. Dr. Arkader or an immediate family member serves as an unpaid consultant to OrthoPediatrics SAB. Dr. Warner or an immediate family member serves as an unpaid consultant to Medtronic Sofamor Danek. Dr. Conway or an immediate family member has received research or institutional support from Sanofi-Aventis; and serves as a board member, owner, officer, or committee member of the Wisconsin Chapter of the American Academy of Pediatrics. Dr. Noonan or an immediate family member has received royalties from Zimmer Biomet; serves as a paid consultant to or is an employee of Zimmer Biomet; and has stock or stock options held in Fixx Orthopedics. Neither Mr. Brusalis nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article. Journal of the American Academy of Orthopaedic Surgeons: September 2016 - Volume 24 - Issue 9 - p e112-e121 doi: 10.5435/JAAOS-D-15-00714 Metrics Abstract Musculoskeletal infections, including osteomyelitis, septic arthritis, and pyomyositis, are a substantial cause of morbidity in children and adolescents. The increased virulence of infectious agents and the increased prevalence of antimicrobial-resistant pathogens, particularly methicillin-resistant Staphylococcus aureus, have resulted in a more complicated clinical course for diagnosis and management, which is evidenced by an increased length of hospital stays, incidence of complications, and number of surgical interventions. Musculoskeletal infections are a challenge for surgeons because they vary substantially in their presentation and in their required treatment, which is based on the causative organism, the location of the infection, and the age of the patient. The necessity for a prompt diagnosis is complicated by several diseases that may mimic musculoskeletal infection, including transient synovitis, autoimmune arthritis, and tumors. Recent innovations in diagnosis and management have provided surgeons with new options to differentiate musculoskeletal infections from these rapidly evolving disease pathologies. As diagnostic and treatment modalities improve, collaboration among surgeons from multiple disciplines is required to develop evidence-based clinical practice guidelines that minimize the effect of musculoskeletal infection and optimize clinical outcomes for patients. Copyright 2016 by the American Academy of Orthopaedic Surgeons.