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Introduction Sickle cell disease is the most common molecular disease. The sickling of the haemoglobin S followed by micro-vascular occlusion leads to complications observable in several tissues. Osteoarticular complications represent the most frequent pattern of hospitalization of children with sickle cell disease. This review discusses osteoarticular complications of sickle cell disease in children. Materials and methods This study is a review concerning children <15 years of age. Phenotypes retained are SS, SC and AS, with or without thalassaemia or foetal haemoglobin. Osteomyelitis, arthritis and osteonecrosis are included. Ficat's classification was used for osteonecrosis of femoral head. Discussion Osteomyelitis is the most frequent complication. It is classically due mainly to salmonella species, but currently, several studies have found other microorganisms (Staphylococcus aureus, Streptococcus pneumonia, klebsiella). Multiple sites are affected at the same time. Long bones are the most affected and according to studies, the most frequent are the humerus, the tibia or the femur. Delay to diagnosis often leads to chronic osteomyelitis, with a high risk of orthopaedic sequela. Arthritis can affect all joints. Also due to salmonella and S. aureus, they can have multiple locations. The hip and knee are the favoured sites. Inadequate treatment can result in the destruction of the joints. Avascular osteonecrosis occurs later, after the age of 10. Their evolution is progressive and insidious, explaining the late diagnosis. Osteonecrosis of the femoral head is the most frequent, and poses the problem of hip arthroplasty in children. Conclusion The osteoarticular complications must be hunted in children with sickle cell disease in order to diagnose them early. A quick and efficient treatment enables to avoid serious orthopaedic sequela.

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