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Forty-three children with pyogenic arthritis were analysed. The morbidity following septic arthritis of major joints infants and children continues to be high. The hip was commonest joint involved, followed by the knee. Over half the patients were less than 2 years old and many presented with foci of infection elsewhere in the body. The erythrocyte sedimentation rate was a more useful index to diagnosis than the total leucocyte count. Demonstration of pus by aspiration or arthrotomy was the most specific diagnostic test. Staphylococcus aureus was the commonest offending organism. Children presenting late following treatment elsewhere had a higher percentage of negative culture. Children presenting early had a satisfactory result with good restoration of joint function. Those presenting later than one week showed radiological changes and had a larger percentage of poor results. Early diagnosis, emergency arthrotomy followed by the appropriate antibiotics, and immobilization increase the chance of obtaining a satisfactory result.